Margioula-Siarkou Chrysoula, Almperis Aristarchos, Gullo Giuseppe, Almperi Emmanouela-Aliki, Margioula-Siarkou Georgia, Nixarlidou Eleni, Mponiou Konstantina, Papakotoulas Pavlos, Sardeli Chrysanthi, Guyon Frederic, Dinas Konstantinos, Petousis Stamatios
2nd Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Department of Obstetrics and Gynaecology, University of Palermo, 90133 Palermo, Italy.
J Clin Med. 2023 Dec 20;13(1):27. doi: 10.3390/jcm13010027.
Cervical cancer (CC) continues to be a significant global public health concern, even with preventive measures in place. In women with early-stage CC, the status of lymph nodes is of paramount importance, not only for the final prognosis but also for determining the best therapeutic strategy. According to main international guidelines, pelvic full lymphadenectomy (PLND) is recommended for lymph node staging. However, in these early stages of CC, sentinel lymph node biopsy (SLNB) has emerged as a precise technique for evaluating lymph node involvement, improving its morbidity profile. We performed a literature review through PubMed articles about progress on the application of SLNB in women with early-stage CC focusing on the comparison with PET/CT and PLND in terms of oncological outcomes and diagnostic accuracy. While the superiority of SLNB is clear compared to radiologic modalities, it demonstrates no clear oncologic inferiority over PLND, given the higher detection rate of positive lymph nodes and predominance of no lymph node recurrences. However, due to a lack of prospective evidence, particularly concerning long-term oncological safety, SLNB is not the current gold standard. With careful patient selection and adherence to straightforward protocols, a low false-negative rate can be ensured. The aim of the ongoing prospective trials is to address these issues.
宫颈癌（CC）仍然是一个重大的全球公共卫生问题，即便已有预防措施。对于早期宫颈癌女性患者，淋巴结状态至关重要，这不仅关乎最终预后，还对确定最佳治疗策略起着决定性作用。根据主要国际指南，盆腔根治性淋巴结清扫术（PLND）被推荐用于淋巴结分期。然而，在宫颈癌的这些早期阶段，前哨淋巴结活检（SLNB）已成为评估淋巴结受累情况的一种精确技术，改善了其发病情况。我们通过PubMed文章对SLNB在早期宫颈癌女性患者中的应用进展进行了文献综述，重点关注其在肿瘤学结局和诊断准确性方面与PET/CT及PLND的比较。虽然与放射学检查方式相比，SLNB的优势明显，但鉴于其对阳性淋巴结的检出率更高且淋巴结无复发情况占主导，它在肿瘤学方面并不明显劣于PLND。然而，由于缺乏前瞻性证据，尤其是关于长期肿瘤学安全性的证据，SLNB目前并非金标准。通过仔细的患者选择和严格遵循简单的方案，可以确保较低的假阴性率。正在进行的前瞻性试验旨在解决这些问题。
