子宫内膜癌前哨淋巴结定位:我们在资源有限的情况下的初步经验。

IF 0.8 Q4 SURGERY
Chirurgia Pub Date : 2025-08-01 DOI:10.21614/chirurgia.3155
Szilárd Leó Kiss, Mihai Stanca, Dan Mihai Căpîlna, Tudor Emil Căpîlna, Maria Pop-Suciu, Botond Istvan Kiss, Szilárd Leó Kiss, Mihai Emil Căpîlna
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引用次数: 0

摘要

背景:淋巴结状态是子宫内膜癌(EC)最重要的预后因素之一,但系统性淋巴结切除术与显著的发病率相关。前哨淋巴结(SLN)定位提供了一种侵入性较小的选择。然而,在无法获得吲哚菁绿的情况下,数据有限。方法:在2019年11月至2025年3月期间,29名FIGO I-III期EC女性前瞻性纳入本研究。宫颈注射亚甲蓝(含或不含锝-99m)进行SLN定位。常规进行超存储。对于高危患者,也行全盆腔和腹主动脉旁淋巴结切除术。计算检出率、敏感性和阴性预测值(NPV)。结果:总检出率为75%,双侧检出率为48%(亚甲蓝:72% / 44%;双示踪剂:100% / 75%)。29例患者中有9例(31%)存在淋巴结转移。患者水平的敏感性为71%,NPV为88%。应用特定侧面完井算法,灵敏度提高到86%。侧特异性灵敏度和NPV均达到100%。淋巴血管间隙浸润和50%肌层浸润与淋巴结转移有显著相关性(p < 0.05)。未观察到与定位相关的并发症。结论:亚甲基蓝SLN定位,有或没有锝,结合侧特异性完成算法,即使没有荧光成像,也能实现可靠的淋巴结分期。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sentinel Lymph Node Mapping in Endometrial Cancer: Our Initial Experience in a Resource Limited Setting.

Background: Nodal status is one of the most important prognostic factors in endometrial cancer (EC), but systematic lymphadenectomy is associated with significant morbidity. Sentinel lymph node (SLN) mapping offers a less invasive alternative. However, data are limited where indocyanine green is unavailable. Methods: Between November 2019 and March 2025, 29 women with FIGO stage I-III EC were prospectively enrolled in this study. Cervical injection of methylene blue, with or without technetium-99m, was used for SLN mapping. Ultrastaging was performed routinely. In patients with high-risk disease, full pelvic and para-aortic lymphadenectomy was also performed. Detection rates, sensitivity, and negative predictive value (NPV) were calculated. Results: Overall and bilateral detection rates were 75% and 48%, respectively (methylene blue: 72% / 44%; dual tracer: 100% / 75%). Nodal metastases were identified in 9 of 29 patients (31%). Patient-level sensitivity was 71%, with an NPV of 88%. Application of the side-specific completion algorithm increased sensitivity to 86%. Side-specific sensitivity and NPV reached 100%. Lymphovascular space invasion and 50% myometrial invasion were significantly associated with nodal metastasis (p 0.05). No mapping-related complications were observed. Conclusions: SLN mapping with methylene blue, with or without technetium, combined with a side-specific completion algorithm, enables reliable nodal staging even without fluorescence imaging.

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来源期刊
Chirurgia
Chirurgia Medicine-Surgery
CiteScore
1.00
自引率
0.00%
发文量
75
审稿时长
4-8 weeks
期刊介绍: Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither appeared, nor were sent for publication in other periodicals, can be published. You can send original articles, new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and, depending on publication space, - reviews of some articles of general interest to surgeons from other publications. Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and participation notes in other scientific meetings. Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please submit these letters to the editor through our online system.
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