使用吲哚菁绿注射法进行前哨淋巴结定位在子宫内膜癌早期阶段失败的预测因素：一项单中心前瞻性研究。
Predictors for sentinel lymph node mapping failure using indocyanine green injection in apparent early stages of endometrial cancer: A single-center prospective study.
作者信息
Bretová Petra, Minář Luboš, Ovesná Petra, Weinberger Vít, Felsinger Michal, Koblížková Michaela, Hausnerová Jitka, Jandáková Eva, Stupková Tatiana
机构信息
Department of Gynecology and Obstetrics, University Hospital Brno, Brno, Czech Republic.
Faculty of Medicine, Masaryk University, Brno, Czech Republic.
出版信息
Int J Gynaecol Obstet. 2025 Sep;170(3):1214-1224. doi: 10.1002/ijgo.70123. Epub 2025 Apr 10.
OBJECTIVE
The current study aimed to analyze predictive factors of sentinel lymph node mapping failure in apparently early stages of endometrial cancer using intracervical indocyanine green injection.
METHODS
A single-center prospective study was conducted between June 2019 and August 2023 at the Department of Gynecology and Obstetrics, University Hospital Brno, Czech Republic. All patients with apparently early stage (I or II according to FIGO [International Federation of Gynecology & Obstetrics] 2009) endometrial cancer, who were indicated for sentinel node biopsy were consecutively included. The injection of 4-6 mL of indocyanine green was applied superficially and deeply into cervical tissue at the 3- and 9-o'clock positions. Patients' clinical data, surgical characteristics, and histopathological information were recorded. Univariable and multivariable regression analyses were applied.
RESULTS
A total of 225 patients were eligible during the study period. Considering bilateral and unilateral failed mapping together, the only statistically significant factors for risk of failure in univariable analysis were body mass index (BMI; P = 0.036), FIGO 2009 stage (P = 0.019), and the presence of a myoma (P = 0.017). Nevertheless, when the multivariable logistic regression analysis was applied, all factors became statistically insignificant except for myoma (P = 0.031). Regarding only bilateral mapping failure, in univariable analysis, BMI (P = 0.021) and FIGO 2009 stage (P = 0.046) were significant predictors of failure. Interestingly, multivariable logistic regression analysis revealed that in addition to BMI (P = 0.007), age (P = 0.004) was also an independent predictor of bilateral failure.
CONCLUSIONS
Higher BMI and age were statistically significant independent factors for bilateral sentinel node mapping failure in early-stage endometrial cancer.
目的
本研究旨在分析使用宫颈内注射吲哚菁绿在子宫内膜癌明显早期阶段前哨淋巴结映射失败的预测因素。
方法
2019年6月至2023年8月在捷克布尔诺大学医院妇产科进行了一项单中心前瞻性研究。所有明显处于早期（根据国际妇产科联盟[FIGO]2009年标准为I期或II期）且被建议进行前哨淋巴结活检的子宫内膜癌患者均被连续纳入。在宫颈组织的3点和9点位置浅表和深部注射4 - 6毫升吲哚菁绿。记录患者的临床数据、手术特征和组织病理学信息。应用单变量和多变量回归分析。
结果
研究期间共有225例患者符合条件。将双侧和单侧映射失败合并考虑，单变量分析中唯一具有统计学意义的失败风险因素是体重指数（BMI；P = 0.036）、FIGO 2009分期（P = 0.019）和肌瘤的存在（P = 0.017）。然而，当应用多变量逻辑回归分析时，除肌瘤外所有因素均无统计学意义（P = 0.031）。仅考虑双侧映射失败时，单变量分析中，BMI（P = 0.021）和FIGO 2009分期（P = 0.046）是失败的显著预测因素。有趣的是，多变量逻辑回归分析显示，除BMI（P = 0.007）外，年龄（P = 0.004）也是双侧失败的独立预测因素。
结论
较高的BMI和年龄是早期子宫内膜癌双侧前哨淋巴结映射失败的统计学显著独立因素。
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