Hou Hongyi, Dai Yibo, Liang Sichen, Wang Zhiqi, Wang Jianliu
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
J Oncol. 2021 Apr 16;2021:5510623. doi: 10.1155/2021/5510623. eCollection 2021.
A total of 100 cervical cancer patients undergoing laparoscopic surgery with SLN biopsy were included. Indocyanine green, carbon nanoparticles (CNPs), and a combination of both were used during surgeries. Detection rates, sensitivity, negative predictive value (NPV) of SLN biopsy, and related factors were analyzed.
The overall and bilateral SLN detection rates were 92% (92/100) and 74% (74/100), respectively. Combined tracers had higher bilateral SLN detection rates than CNPs alone (=0.005). Menopause and lymph node metastasis were associated with lower overall and bilateral SLN detection rates ( < 0.05). SLN biopsy sensitivity and NPV for lymph node metastasis in patients with at least one detected SLN were 81.8% (9/11) and 97.3% (72/74), respectively. Among those with bilateral detected SLNs, higher sensitivity and NPV of 87.5% (7/8) and 98.3% (57/58) were observed, respectively. SLN algorithm can ensure that all patients with lymph node metastasis are detected by SLN biopsy.
SLN biopsy appears to be safe and effective for specific cervical cancer patients with high detection rates and NPV in laparoscopic surgery, especially for those with detected bilateral SLNs and undergoing the SLN algorithm. Selecting suitable patients for SLN mapping has prospects for clinical application.
纳入100例行腹腔镜手术并进行前哨淋巴结活检的宫颈癌患者。手术过程中使用了吲哚菁绿、碳纳米颗粒（CNPs）以及两者的组合。分析前哨淋巴结活检的检出率、敏感性、阴性预测值（NPV）及相关因素。
总的前哨淋巴结检出率和双侧前哨淋巴结检出率分别为92%（92/100）和74%（74/100）。联合示踪剂的双侧前哨淋巴结检出率高于单独使用CNPs（=0.005）。绝经和淋巴结转移与总的及双侧前哨淋巴结检出率降低相关（<0.05）。至少检测到一枚前哨淋巴结的患者，前哨淋巴结活检对淋巴结转移的敏感性和NPV分别为81.8%（9/11）和97.3%（72/74）。在双侧检测到前哨淋巴结的患者中，敏感性和NPV更高，分别为87.5%（7/8）和98.3%（57/58）。前哨淋巴结算法可确保所有有淋巴结转移的患者通过前哨淋巴结活检被检测到。
对于特定的宫颈癌患者，前哨淋巴结活检在腹腔镜手术中似乎是安全有效的，具有较高的检出率和NPV，特别是对于那些双侧检测到前哨淋巴结并采用前哨淋巴结算法的患者。选择合适的患者进行前哨淋巴结定位具有临床应用前景。
