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虽然前哨淋巴结(Sentinel lymph node,SLN)检测在子宫内膜癌领域还属于探索阶段,但多项研究表明SLN检测在早期子宫内膜癌是可行的。蓝染和放射性胶体联合检测方法可以提高SLN检出率;子宫体多点注射法和经宫腔镜子宫内膜注射法较宫颈注射法比较,可以提高SLN检出率和主动脉旁SLN阳性率。此外SLN检出率还与示踪物剂量、注射到检测的间隔时间以及肿瘤浸润子宫肌层深度有关。连续切片及抗细胞角蛋白免疫组化方法的联合应用可以提高SLN微转移(MM)的检出率。SLN的重要意义不仅是替代淋巴结切除术,更多在于它能够检测出传统的病理学检查不能发现的MM。其“超”分期作用可以诊断出中危度子宫内膜癌患者并对其提供及时的辅助治疗,减少复发。
Although the detection of Sentinel lymph node (SLN) is still in the exploratory stage in the field of endometrial cancer, a number of studies have shown that SLN detection is feasible in early stage of endometrial cancer. Blue staining and radioactive colloid combined detection method can increase the detection rate of SLN; uterine body multi-point injection and endometrial injection by hysteroscopy than cervical injection method can increase the detection rate of SLN and aortic SLN positive rate . In addition SLN detection rate is also related to the tracer dose, injection time to detect the tumor invasion and depth of myometrial related. The combination of serial sections and anti-cytokeratin immunohistochemistry can improve the detection rate of SLN micrometastases (MM). The significance of SLN is not only an alternative to lymph node dissection, but also its ability to detect MM that can not be detected by conventional pathology. Its “ultra ” staging can diagnose patients with moderate-risk endometrial cancer and provide timely adjuvant treatment to reduce recurrence.