Weiner S A, Lee J K, Kao M S, Moon T E
Am J Obstet Gynecol. 1986 May;154(5):1073-5. doi: 10.1016/0002-9378(86)90753-2.
The records of all patients with vulvar carcinoma seen at Washington University School of Medicine between 1970 and 1983 were reviewed to determine the role of lymphangiography in the management of patients with vulvar malignancy. Forty-three patients were identified who had a preoperative lymphangiogram followed by radical vulvectomy and lymph node dissection. Thirty-two films were available for review. Seventy-seven sets of lymph nodes were obtained from the 32 patients. Overall diagnostic accuracy was 42 of 77 (54.5%), with a sensitivity of three of 19 (15.7%) and a specificity of 39 of 59 (66.1%). Corresponding values for inguinal nodes were 26 of 57 (45.6%), two of 16 (12.5%), and 24 of 41 (58.5%), respectively. Accuracy rates for pelvic nodes were 16 of 21 (76.2%) with a sensitivity rate of one of three (33%) and a specificity of 15 of 18 (83%). Negative scans were more likely to be accurate than positive scans, 88.6% versus 30%. While a negative lymphangiogram may be helpful in predicting the absence of metastases, its poor specificity limits its widespread usefulness.
回顾了1970年至1983年间在华盛顿大学医学院就诊的所有外阴癌患者的记录，以确定淋巴管造影在外阴恶性肿瘤患者管理中的作用。确定了43例患者，他们在术前进行了淋巴管造影，随后进行了根治性外阴切除术和淋巴结清扫术。有32份片子可供审查。从这32例患者中获取了77组淋巴结。总体诊断准确率为77例中的42例（54.5%），敏感性为19例中的3例（15.7%），特异性为59例中的39例（66.1%）。腹股沟淋巴结的相应值分别为57例中的26例（45.6%）、16例中的2例（12.5%）和41例中的24例（58.5%）。盆腔淋巴结的准确率为21例中的16例（76.2%），敏感性为3例中的1例（33%），特异性为18例中的15例（83%）。阴性扫描比阳性扫描更可能准确，分别为88.6%和30%。虽然阴性淋巴管造影可能有助于预测无转移，但它较差的特异性限制了其广泛应用。
