摘要
目的:探讨腹腔镜下应用纳米炭混悬液检测前哨淋巴结(SLN)在早期宫颈癌患者中的识别价值。方法:选取2014年1月至2016年1月在广西医科大学附属肿瘤医院行手术治疗的ⅠA2~ⅡA期宫颈癌患者40例。术前从宫颈3、9点注射纳米炭混悬注射液,腹腔镜直视下识别最先黑染淋巴结作为SLN并切取,单独行病理检查及免疫组化检查。切取SLN后,患者均行腹腔镜下盆腔淋巴结切除术+根治性子宫切除(±腹主动脉旁淋巴结取样术)。结果:40例患者中,38例成功检出至少1枚SLN,检出率为95%(38/40),共检出173枚SLN,平均每例每侧3.9枚SLN。8例(20%)患者共检出29枚阳性淋巴结,其中包括6例患者的阳性SLN,共25枚(86.20%)。前哨淋巴结定位于闭孔37.52%,髂外29.52%,髂内13.94%,宫旁5.09%,髂总12.13%。SLN检测的灵敏度为75%(6/8),准确性为100.0%(38/38),阴性预测值为100.0%(29/29)。结论:早期宫颈癌SLN的转移状态同盆腔淋巴结真实转移状态一致性较高,闭孔淋巴结为SLN检出频次最高的淋巴结,腹腔镜下纳米炭示踪早期宫颈癌SLN具有可行性。
Objective： To investigate the value of Carbon Nanoparticles in identifying Sentinel lymph nodes of early cervical cancer.Methods： Between Jan.2014 an Jan.2016,40 patients in cervical cancer stage IA2 - IIA according FIGO 2000 were underwent the study.Carbon Nanoparticles was injected into the cervix around the tumor or 3,9 point of normal appearance cervix.All the patients were underwent laparoscopic pelvic lymph node dissection and radical hysterectomy,excising the sentinel lymph nodes which were black dye for pathological examination and immunohistochemical staining usually. Results： Of these 40 patients,at least one SLN was successfully detected in 38 patients（ 95%）,and a total of 171 SLNs were detected. The conventional pathology results suggested that 9 patients（ 22.5%） had positive lymph nodes（ n= 29,including 25 SLN in 6 patients）. Sentinel lymph nodes localization in obturator area（ 37.52%）,internal lilac area（ 13.94%）,external lilac area（ 29. 52%）,parametrial area（ 5. 09%）,iliac lymph nodes area（ 12.13%）. The new approach showed a sensitivity of 77.8%（ 7 / 9）,accuracy of 100.0%（ 20 / 20）,and negative predictive value of 100. 0%（ 16 / 16） for SLN detection.Conclusions： SLNs can accurately predict the pathological state of pelvic lymph nodes in cervical cancer.And the detection rates and accuracy of SLNs were higher.Carbon Nanoparticles can be used to trace the SLNs in cervical cancer.
出处
《现代妇产科进展》
CSCD
北大核心
2017年第2期109-112,115,共5页
Progress in Obstetrics and Gynecology
关键词
纳米碳
腹腔镜
前哨淋巴结
宫颈癌
Carbon nanoparticles
Laparoscopy
Sentinel lymph nodes
Cervical cancer
