前哨淋巴结绘图在子宫内膜癌手术中的应用

发布时间：2018-03-03 06:49

本文选题：子宫内膜癌　切入点：前哨淋巴结　出处：《中华腔镜外科杂志(电子版)》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨亚甲蓝示踪前哨淋巴结(SLN)绘图在子宫内膜癌手术中的应用价值。方法67例子宫内膜癌患者行(广泛)全子宫+双附件切除+盆腔±腹主动脉旁淋巴结清扫术,术前2 h于宫颈3、6、9、12点钟位置注射亚甲蓝,术中识别并记录蓝染SLN的部位、数量。术后所有淋巴结经苏木精-伊红染色及免疫组化病理学检查。结果 67例患者中腹腔镜手术53例,机器人手术14例。总体及双侧盆腔SLN检出率分别为82.0%(55/67)及71.6%(48/67),灵敏度87.5%(7/8),假阴性率12.5%(1/8)。切除SLN、盆腔淋巴结、腹主动脉旁淋巴结的中位数分别为2、7、0枚。SLN集中分布于闭孔窝及髂外血管周围。结论亚甲蓝示踪SLN绘图具有灵敏度高、操作简便的优点,可作为子宫内膜癌手术中预测盆腔淋巴结转移情况的常规方法。
[Abstract]:Objective to evaluate the value of SLN mapping with methylene blue tracer in the operation of endometrial carcinoma. Methods 67 patients with endometrial carcinoma underwent (extensive) total double appendage resection of pelvic 卤abdominal aorta lymph node dissection. Methylene blue was injected at 12 o'clock in the cervix of the cervix 2 hours before operation. The site of blue stained SLN was identified and recorded during the operation. Number. All lymph nodes were examined by hematoxylin-eosin staining and immunohistochemical pathology. Results 53 of 67 patients underwent laparoscopic surgery. The detection rate of total and bilateral pelvic SLN was 82.0 / 67) and 71.6 / 48 / 67 respectively. The sensitivity was 87.5%, and the false negative rate was 12.5% / 8%. The pelvic lymph nodes were resected, and the pelvic lymph nodes were resected. The median of lymph nodes around abdominal aorta was 2 0. SLNs were distributed in the obturator fossa and around the external iliac vessels. Conclusion the methylene blue tracer SLN plot has the advantages of high sensitivity and simple operation. It can be used as a routine method to predict pelvic lymph node metastasis in endometrial carcinoma surgery.
【作者单位】：吉林省肿瘤医院妇科肿瘤二科;吉林省肿瘤医院腹部肿瘤外三科;
【基金】：吉林省卫生科研计划临床应用研究(2013S029)
【分类号】：R737.33

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