超顺磁性氧化铁纳米颗粒作为早期宫颈癌前哨淋巴结定位示踪剂的诊断价值:初步临床经验
Diagnostic Value of Superparamagnetic Iron Oxide Nanoparticles as a Tracer for Sentinel Lymph Node Mapping in Early-Stage Cervical Cancer: The Preliminary Clinical Experience.
作者信息
Jedryka Marcin A, Czekanski Andrzej, Kryszpin Marcin, Poprawski Tymoteusz, Grobelak Krzysztof, Lepka Piotr, Matkowski Rafał
机构信息
Department of Oncology, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Department of Oncologic Gynecology, Lower Silesian Oncology, Hematology and Pulmonology Center, 53-413 Wroclaw, Poland.
出版信息
J Funct Biomater. 2025 May 26;16(6):196. doi: 10.3390/jfb16060196.
Sentinel lymph node (SLN) mapping has been investigated as part of surgical staging in women with early-stage cervical cancer (CC); however, pelvic lymphadenectomy (PLND) remains the standard of care. This study aimed to assess feasibility and safety of SLN detection using superparamagnetic iron oxide (SPIO) nanoparticles as a tracer in CC. Thirty CC patients presumed to be stage I were included in this study with SPIO administered intracervically as a tracer for SLN mapping using a magnetometer and followed by PLND. The endpoints of the study included the proportion of successful SLN detection, the average number of SLNs per patient, and the proportion of pathologically positive results per patient and per node. The diagnostic accuracy of SPIO nanoparticles for detection of metastatic SLNs was evaluated by Receiver Operating Characteristic (ROC) curve analysis, with the area under the ROC curve (AUC) used to demonstrate the studied method's sensitivity. Safety endpoints were a summary of all reported adverse events. SLNs were detected in all cases, bilaterally in 27 patients (90%). The median number of SLNs per patient was 3.5. Four cases had metastatic SLNs. The general malignancy rate per patient was 13.3%, and per node, it was 0.8%. The malignancy detection rate of SLNs was 100% per patient and 80% per node. The AUC of 1.0 ( < 0.001) confirmed the diagnostic value of the SPIO technique for the detection of metastatic SLNs, with a sensitivity of 100%. No adverse events related to the SPIO administration were reported. SPIO nanoparticles, as a tracer for SLN mapping in early-stage CC patients, demonstrated satisfactory accuracy parameters and safety; however, these data need to be evaluated by further research.
前哨淋巴结(SLN)定位已作为早期宫颈癌(CC)女性手术分期的一部分进行了研究;然而,盆腔淋巴结清扫术(PLND)仍是标准的治疗方法。本研究旨在评估使用超顺磁性氧化铁(SPIO)纳米颗粒作为示踪剂在CC中检测SLN的可行性和安全性。30例推测为I期的CC患者纳入本研究,将SPIO经宫颈给药作为示踪剂,使用磁力计进行SLN定位,随后进行PLND。研究终点包括成功检测到SLN的比例、每位患者的SLN平均数量以及每位患者和每个淋巴结的病理阳性结果比例。通过受试者操作特征(ROC)曲线分析评估SPIO纳米颗粒检测转移性SLN的诊断准确性,ROC曲线下面积(AUC)用于证明所研究方法的敏感性。安全终点是所有报告不良事件的汇总。所有病例均检测到SLN,27例患者(90%)为双侧。每位患者SLN的中位数为3.5个。4例有转移性SLN。每位患者的总体恶性率为13.3%,每个淋巴结为0.8%。SLN的恶性检测率每位患者为100%,每个淋巴结为80%。AUC为1.0(<0.001)证实了SPIO技术检测转移性SLN的诊断价值,敏感性为100%。未报告与SPIO给药相关的不良事件。SPIO纳米颗粒作为早期CC患者SLN定位的示踪剂,显示出令人满意的准确性参数和安全性;然而,这些数据需要通过进一步研究进行评估。
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