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联合注射技术在中高危子宫内膜癌前哨淋巴结定位中的效率。

The efficiency of a combined injection technique for sentinel lymph node mapping in intermediate-high-risk endometrial cancer.

机构信息

Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.

Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.

出版信息

J Surg Oncol. 2021 Dec;124(8):1551-1560. doi: 10.1002/jso.26666. Epub 2021 Sep 8.

Abstract

BACKGROUND AND OBJECTIVES

Sentinel lymph node (SLN) mapping was considered for treating endometrial cancer (EC) which was apparent confined to the uterus. Nevertheless, intermediate-high-risk EC patients have super high risk to undergo isolated para-aortic lymph node metastases comparing with low-risk patients. Therefore, this investigation aimed to compare the efficacy of two SLN methods in detecting para-aortic lymph node metastases.

METHODS

According to SLN mapping injection methods, intermediate-high-risk EC patients who received both SLN mapping and systematic lymphadenectomy were divided into the combined group (fundal and cervical injections) and the cervical group (cervical injection only).

RESULTS

The para-aortic SLN detection rate in the combined group (40.4%) was higher than that in the cervical group (4.4%) with p < 0.001. While the differences concerning the sensitivity, false-negative rate, and negative predictive value between the two groups were not significant. The survival outcomes of patients were comparable between the two groups.

CONCLUSION

Our data showcased that the combined (fundal and cervical) injection had a higher detection rate of para-aortic SLNs than cervical injection only. The efficiency of SLN mapping and the survival outcomes were not significantly different between the two groups. Further investigations are warranted to assess the value of combined injection regarding SLN technique.

摘要

背景与目的

前哨淋巴结(SLN)检测已被认为可用于治疗明显局限于子宫的子宫内膜癌(EC)。然而,与低危患者相比,中高危 EC 患者发生孤立性腹主动脉旁淋巴结转移的风险极高。因此,本研究旨在比较两种 SLN 检测方法在检测腹主动脉旁淋巴结转移方面的疗效。

方法

根据 SLN 检测的注射方法,接受 SLN 检测和系统淋巴结清扫术的中高危 EC 患者被分为联合组(宫底和宫颈注射)和宫颈组(仅宫颈注射)。

结果

联合组(40.4%)的腹主动脉 SLN 检出率高于宫颈组(4.4%),p<0.001。然而,两组之间的敏感性、假阴性率和阴性预测值差异无统计学意义。两组患者的生存结局无显著差异。

结论

本研究数据表明,宫底和宫颈联合注射的 SLN 检测率高于仅宫颈注射。SLN 检测的效率和生存结局在两组之间无显著差异。需要进一步研究来评估联合注射在 SLN 技术中的价值。

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