Zhou Fanchen, Qi Bangruo
Department of Gynecology, Dalian Central Hospital Dalian, Liaoning, China.
Department of Obstetrics and Gynecology, Sanya Women and Children's Hospital Sanya, Hainan, China.
Am J Transl Res. 2023 Oct 15;15(10):6115-6121. eCollection 2023.
To explore the significance of intraoperative sentinel lymph node (SLN) identification in endometrial cancer.
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.
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).
Intraoperative SLE identification can avoid false negative results, is safe and feasible, and can prolong the survival time of patients with endometrial cancer.
探讨术中前哨淋巴结(SLN)识别在子宫内膜癌中的意义。
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。
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)。
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。