Department of Surgical Oncology, St Johns Medical College and Hospital, Johnnagara, Bengaluru, Karnataka, 560034, India.
Department of Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.
Cancer Treat Res Commun. 2024;39:100816. doi: 10.1016/j.ctarc.2024.100816. Epub 2024 Apr 27.
To evaluate the effectiveness of methylene blue dye in detecting sentinel lymph nodes (SLNs) in women with early-stage operable (defined as FIGO I-IIA) cervical cancer. It also aims to evaluate procedural challenges and accuracy.
This prospective study, which focused on 20 women with early-stage cervical cancer, was carried out between June 2016 and December 2017. These patients had SLN mapping with methylene blue dye injections and thorough examinations, including imaging. All patients underwent radical hysterectomy and complete bilateral pelvic lymphadenectomy. No additional investigation was done on the lymph node in cases where a metastasis was found in the first H&E-stained segment of the sentinel node.
20 patients were included in the analysis. The median age of the subjects was 53, and 95 % of them had squamous cell carcinoma. 90 % of the time, the identification of SLNs was effective, and 55 SLNs were found, of which 52.7 % were on the right side of the pelvis and 47.3 % on the left. The obturator group had the most nodes, followed by the external and internal iliac groups in descending order of occurrence. Metastasis was detected in 3 patients, resulting in a sensitivity of 100 % and a specificity of 93.75 % for SLN biopsy. Notably, no false-negative SLNs were found. Complications related to methylene blue usage included urine discoloration in 30 % of patients.
This trial highlights the promising efficacy and safety of methylene blue dye alone for SLN identification in early-stage operable cervical cancer, with a notably higher success rate. Despite limitations like a small sample size, healthcare professionals and researchers can build upon the insights from this study to enhance cervical cancer management.
评估亚甲蓝染料在检测早期可手术（定义为 FIGO I-IIA）宫颈癌患者前哨淋巴结（SLN）中的有效性。还旨在评估程序挑战和准确性。
这项前瞻性研究专注于 20 名早期宫颈癌患者，于 2016 年 6 月至 2017 年 12 月进行。这些患者接受了 SLN 定位，使用亚甲蓝染料注射并进行了彻底的检查，包括影像学检查。所有患者均接受了根治性子宫切除术和双侧完整盆腔淋巴结切除术。如果在第一份 H&E 染色的 SLN 段中发现转移，则不对淋巴结进行进一步检查。
20 名患者纳入分析。受试者的中位年龄为 53 岁，95%为鳞状细胞癌。90%的时间，SLN 的识别是有效的，发现了 55 个 SLN，其中 52.7%位于骨盆右侧，47.3%位于骨盆左侧。闭孔组的淋巴结最多，其次是外髂组和内髂组，按出现频率依次降低。3 名患者检测到转移，SLN 活检的敏感性为 100%，特异性为 93.75%。值得注意的是，未发现假阴性 SLN。与亚甲蓝使用相关的并发症包括 30%的患者出现尿液变色。
本试验强调了亚甲蓝染料单独用于早期可手术宫颈癌 SLN 识别的有前景的疗效和安全性，成功率显著提高。尽管存在样本量小等局限性，但医疗保健专业人员和研究人员可以从这项研究中汲取经验，以改善宫颈癌的管理。
