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本文引用的文献

1
Randomized comparison between sentinel lymph node mapping using indocyanine green plus a fluorescent camera versus lymph node dissection in clinical stage I-II endometrial cancer: a Korean Gynecologic Oncology Group trial (KGOG2029/SELYE).采用吲哚菁绿联合荧光摄像的前哨淋巴结显影与淋巴结清扫在临床Ⅰ期-Ⅱ期子宫内膜癌中的随机比较:韩国妇科肿瘤学组研究(KGOG2029/SELYE)。
J Gynecol Oncol. 2022 Nov;33(6):e73. doi: 10.3802/jgo.2022.33.e73. Epub 2022 Jul 25.
2
Randomized Study of Wound Drainage on Early Complications After Lymph Node Dissection for Melanoma.随机研究黑色素瘤淋巴结清扫术后引流对早期并发症的影响。
J Surg Res. 2021 Nov;267:467-476. doi: 10.1016/j.jss.2021.05.005. Epub 2021 Jul 7.
3
Sentinel node biopsy for diagnosis of lymph node involvement in endometrial cancer.前哨淋巴结活检用于诊断子宫内膜癌的淋巴结受累情况。
Cochrane Database Syst Rev. 2021 Jun 9;6(6):CD013021. doi: 10.1002/14651858.CD013021.pub2.
4
Operative and Oncological Outcomes Comparing Sentinel Node Mapping and Systematic Lymphadenectomy in Endometrial Cancer Staging: Meta-Analysis With Trial Sequential Analysis.子宫内膜癌分期中前哨淋巴结定位与系统性淋巴结清扫术的手术及肿瘤学结局比较:采用序贯试验分析的Meta分析
Front Oncol. 2021 Jan 13;10:580128. doi: 10.3389/fonc.2020.580128. eCollection 2020.
5
Near-infrared fluorescence imaging compared to standard sentinel lymph node detection with blue dye in patients with vulvar cancer - a randomized controlled trial.近红外荧光成像与蓝色染料在宫颈癌患者前哨淋巴结检测中的比较——一项随机对照试验。
Gynecol Oncol. 2020 Dec;159(3):672-680. doi: 10.1016/j.ygyno.2020.09.044. Epub 2020 Oct 8.
6
Clinical Activity and Safety of the Anti-Programmed Death 1 Monoclonal Antibody Dostarlimab for Patients With Recurrent or Advanced Mismatch Repair-Deficient Endometrial Cancer: A Nonrandomized Phase 1 Clinical Trial.抗程序性死亡 1 单克隆抗体 dostarlimab 治疗复发性或晚期错配修复缺陷型子宫内膜癌患者的临床活性和安全性:一项非随机 1 期临床试验。
JAMA Oncol. 2020 Nov 1;6(11):1766-1772. doi: 10.1001/jamaoncol.2020.4515.
7
The role of sentinel lymph node mapping in endometrial carcinoma.前哨淋巴结绘图在子宫内膜癌中的作用。
Minerva Ginecol. 2020 Dec;72(6):367-383. doi: 10.23736/S0026-4784.20.04626-2. Epub 2020 Sep 14.
8
Diagnostic value of frozen section examination of sentinel lymph nodes in early-stage cervical cancer at the time of ultrastaging.超声分期时前哨淋巴结冰冻切片检查在早期宫颈癌中的诊断价值。
Gynecol Oncol. 2020 Sep;158(3):576-583. doi: 10.1016/j.ygyno.2020.05.043. Epub 2020 Jun 25.
9
Potential risks in sentinel lymph node biopsy for cervical cancer: a single-institution pilot study.宫颈癌前哨淋巴结活检的潜在风险:单中心初步研究。
World J Surg Oncol. 2020 Jun 18;18(1):133. doi: 10.1186/s12957-020-01905-9.
10
Indocyanine Green Fluorescence Versus Blue Dye or Radioisotope Regarding Detection Rate of Sentinel Lymph Node Biopsy and Nodes Removed in Breast Cancer: A Systematic Review and Meta-Analysis.吲哚菁绿荧光法与蓝染法或放射性同位素法检测乳腺癌前哨淋巴结活检和切除淋巴结的检出率:系统评价和荟萃分析。
Asian Pac J Cancer Prev. 2020 May 1;21(5):1187-1195. doi: 10.31557/APJCP.2020.21.5.1187.

子宫内膜癌术中前哨淋巴结识别可有效指导治疗。

Endometrial cancer intraoperative sentinel lymph node identification can effectively guide treatment.

作者信息

Zhou Fanchen, Qi Bangruo

机构信息

Department of Gynecology, Dalian Central Hospital Dalian, Liaoning, China.

Department of Obstetrics and Gynecology, Sanya Women and Children's Hospital Sanya, Hainan, China.

出版信息

Am J Transl Res. 2023 Oct 15;15(10):6115-6121. eCollection 2023.

PMID:37969178
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10641342/
Abstract

OBJECTIVE

To explore the significance of intraoperative sentinel lymph node (SLN) identification in endometrial cancer.

METHODS

We retrospectively analyzed the clinical data of 56 patients with intraoperative SLN recognition (group A) and 50 patients without intraoperative SLN recognition (group B). SLN and pelvic abdominal lymph node distribution, SLN recognition rate, SLN recognition effect, mortality, the incidence of adverse events, and cumulative survival rate were statistically analyzed.

RESULTS

SLN were identified and removed in 41 of the 56 patients, with a recognition rate of 82.14% (46/56). The sensitivity of SLN was 83.72%, the specificity was 84.62%, and the negative predictive value was 61.11%. There were 15 patients with no SLN metastasis found in the pathological examination during the operation, among which two patients with poorly differentiated adenocarcinoma and clinical stage II patients underwent immunohistochemical staining, and three patients showed SLN micro-metastasis but no cancer tissue metastasis in the lymph node dissection. There was no significant difference in the incidence of total adverse events between group A and group B (>0.05). The cumulative survival rate of group A was higher than that of group B (=0.018).

CONCLUSION

Intraoperative SLE identification can avoid false negative results, is safe and feasible, and can prolong the survival time of patients with endometrial cancer.

摘要

目的

探讨术中前哨淋巴结(SLN)识别在子宫内膜癌中的意义。

方法

回顾性分析56例术中识别SLN患者(A组)和50例未术中识别SLN患者(B组)的临床资料。对SLN及盆腔腹主动脉旁淋巴结分布、SLN识别率、SLN识别效果、死亡率、不良事件发生率及累积生存率进行统计学分析。

结果

56例患者中41例成功识别并切除SLN,识别率为82.14%(46/56)。SLN的敏感度为83.72%,特异度为84.62%,阴性预测值为61.11%。术中病理检查发现15例无SLN转移,其中2例低分化腺癌及临床Ⅱ期患者行免疫组化染色,3例显示SLN微转移但淋巴结清扫未见癌组织转移。A组与B组总不良事件发生率差异无统计学意义(>0.05)。A组累积生存率高于B组(=0.018)。

结论

术中识别SLN可避免假阴性结果,安全可行,可延长子宫内膜癌患者生存时间。