Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.
Department of Pathology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.
J Surg Oncol. 2024 Feb;129(2):403-409. doi: 10.1002/jso.27486. Epub 2023 Oct 19.
The objective of this study is to establish the detection rate of sentinel lymph node (SLN) biopsies and to determine the sensitivity and false-negative rate of SLN biopsies compared with those of systematic pelvic and para-aortic lymphadenectomies in endometrial cancer.
This prospective cohort study enrolled patients with endometrial cancer who were scheduled for surgical staging. Patients with a history of chemotherapy or radiotherapy, an abnormal liver function test, or an allergy to indocyanine green (ICG) were excluded. All patients underwent surgical staging with an ICG injection at the cervix. SLNs were identified by a near-infrared fluorescent camera. All SLNs were sent to a pathologist for ultrastaging.
From November 2019 to June 2023, 142 patients underwent SLN mapping and surgical staging. SLNs were not detected bilaterally in 8 patients. The detection rate of the SLN biopsies in this study was 91.2%. Thus, the accuracy of the SLN biopsies was 97.6%. The sensitivity for finding metastatic SLNs was 84.2%, with a negative predictive value of 97.22%.
A SLN biopsy in endometrial cancer has a high detection rate and high accuracy. However, surgical expertise and a learning curve are required.
本研究旨在确定前哨淋巴结（SLN）活检的检出率，并比较其与系统盆腔和腹主动脉淋巴结清扫术在子宫内膜癌中的敏感性和假阴性率。
本前瞻性队列研究纳入了计划接受手术分期的子宫内膜癌患者。排除了有化疗或放疗史、肝功能异常或对吲哚菁绿（ICG）过敏的患者。所有患者均在宫颈处注射 ICG 后进行手术分期。使用近红外荧光相机识别 SLN。所有 SLN 均由病理科医生进行超分期。
从 2019 年 11 月至 2023 年 6 月，共 142 例患者接受了 SLN 定位和手术分期。8 例患者双侧均未检出 SLN。本研究中 SLN 活检的检出率为 91.2%。因此，SLN 活检的准确率为 97.6%。发现转移性 SLN 的敏感性为 84.2%，阴性预测值为 97.22%。
子宫内膜癌的 SLN 活检具有较高的检出率和准确率，但需要手术专业知识和学习曲线。
