论文部分内容阅读
目的:评价早期宫颈癌前哨淋巴结(SLN)活检的必要性、准确性及临床应用价值。方法:将80例早期宫颈癌患者分别应用生物活性染料亚甲蓝和99Tcm-硫胶体检测SLN,阴性SLN及非SLN行CK19免疫组化检查。结果:80例患者中76例成功检测出227枚SLN,蓝染法、放射性同位素法和联合法检出率分别为80.0%、90.0%和96.0%(P=0.03),后30例蓝染法检出率达93.3%。SLN检测的灵敏性为78.9%(15/19),准确性为97.4%(74/76),假阴性率为10.5%(2/19)。SLN的分布:髂内闭孔174枚(77%),髂外淋巴结40枚(18%),髂总10枚(4%),子宫旁3枚(1%)。408枚阴性的SLN及非SLN CK19免疫组化检测均阴性。结论:早期宫颈癌SLN的检测是方便易行的,检测规范有待明确,SLN的区域淋巴结病理代表性需要进一步评价。宫颈癌SLN检测中合适的微转移检测方法及临床意义有待考证。
Objective: To evaluate the necessity, accuracy and clinical value of sentinel lymph node (SLN) biopsy in early cervical cancer. Methods: 80 cases of early cervical cancer patients were detected by immunohistochemical staining of SLN, negative SLN and non-SLN with biologically active dye methylene blue and 99Tcm-sulfur colloids respectively. RESULTS: Totally 227 SLNs were detected in 76 out of 80 patients. The detection rates of blue staining, radioisotope and combined detection were 80.0%, 90.0% and 96.0% respectively (P = 0.03) Detection rate of 93.3%. The sensitivity of SLN was 78.9% (15/19), the accuracy was 97.4% (74/76) and the false negative rate was 10.5% (2/19). The distribution of SLNs was 174 (77%) in the iliac obturator, 40 (18%) in the external iliac lymph nodes, 10 (4%) in the iliac and 3 (1%) in the uterus. 408 negative SLN and non-SLN CK19 immunohistochemical tests were negative. Conclusion: The detection of SLN in early stage of cervical cancer is convenient and easy to operate. The test specification needs to be clarified. The pathological representation of regional lymph nodes in SLN needs further evaluation. Cervical cancer SLN detection of appropriate micrometastasis detection methods and clinical significance remains to be verified.