Mäkelä P J, Leminen A, Kääriäinen M, Lehtovirta P
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
J Ultrasound Med. 1993 May;12(5):255-8. doi: 10.7863/jum.1993.12.5.255.
The state of the inguinal nodes is a major prognostic factor in vulvar carcinoma. Because of new surgical trends with selective inguinal lymphadenectomy, the preoperative evaluation of inguinal lymph nodes is essential for adequate treatment of vulvar carcinoma. To evaluate the adequacy of clinical examination and high-frequency transducer sonography in detecting metastatic inguinal lymph nodes, we studied 25 patients with vulvar malignancy who underwent operation. Histopathologically proved lymph node metastases were found in 11 (22%) of 50 inguinal areas studied. All of the suspected metastases were in patients with stage III-IV disease. The inguinal lymph node metastases were found by sonography in nine (82%), by preoperative palpation in one (9%), and by operative palpation in six (55%) of 11 areas. The difference between sonography and palpation was statistically significant (P < 0.01). The sensitivity and specificity were 82% and 87% for sonography, 9% and 100% for preoperative palpation, and 55% and 90% for operative palpation.
腹股沟淋巴结状态是外阴癌的一个主要预后因素。由于选择性腹股沟淋巴结清扫术这一新的手术趋势，腹股沟淋巴结的术前评估对于外阴癌的充分治疗至关重要。为了评估临床检查和高频探头超声检查在检测腹股沟转移性淋巴结方面的充分性，我们研究了25例行手术的外阴恶性肿瘤患者。在所研究的50个腹股沟区域中，经组织病理学证实有11个区域（22%）存在淋巴结转移。所有疑似转移均见于III-IV期疾病患者。在11个区域中，通过超声检查发现9个区域（82%）有腹股沟淋巴结转移，术前触诊发现1个区域（9%）有转移，术中触诊发现6个区域（55%）有转移。超声检查与触诊之间的差异具有统计学意义（P < 0.01）。超声检查的敏感性和特异性分别为82%和87%，术前触诊为9%和100%，术中触诊为55%和90%。
