纳米碳示踪前哨淋巴结检测技术在腹腔镜下早期子宫内膜癌手术中的应用

郭苏阳; 李玉芝; 杨波; 马珊珊; 张庆松

doi:10.13898/j.cnki.issn.1000-2200.2020.06.009

纳米碳示踪前哨淋巴结检测技术在腹腔镜下早期子宫内膜癌手术中的应用

Application value of nano carbon tracing sentinel lymph node detection technique in laparoscopic surgery of early endometrial cancer

摘要

摘要:
目的探讨纳米炭示踪前哨淋巴结（SLN）检测技术在腹腔镜下早期子宫内膜癌手术中的临床价值。
方法40例早期子宫内膜癌病人行腹腔镜下全子宫双附件+盆腔和/或腹主动脉旁淋巴结清扫术，术中行纳米炭示踪SLN显影识别，记录黑染的SLN的检测情况，术后将切除的淋巴结病理检查。
结果40例病人中37例共检测出黑染淋巴结142枚，平均3.8枚/人，检出率为92.5%。SLN的检出率在不同注射部位、不同分期、不同肿瘤直径病人中差异均无统计学意义（P>0.05）。子宫内膜癌SLN主要分布在髂外淋巴结（32.4%，46/142）和闭孔淋巴结（25.7%，37/142）。纳米炭示踪SLN的敏感度为100%，阴性预测值为100%。
结论腹腔镜下早期子宫内膜癌术中纳米炭示踪SLN技术是可行的，为判断淋巴结转移的情况及手术范围的选择提供了有效的依据。

Abstract:
ObjectiveTo investigate the clinical value of nano carbon tracing sentinel lymph node(SLN) in laparoscopic surgery for early endometrial cancer.
MethodsForty patients with early endometrial cancer were treated with laparoscopic double appendages combined with pelvic and/or paraaortic lymphadenectomy.During the operation, the SLN were identified using nano carbon tracer, and the detection of black stained SLN was recorded.The pathological examination of the removed lymph nodes after the operation was performed.
ResultsAmong 40 patients, 142 black stained lymph nodes in 37 cases were detected, with an average of 3.8 per patient, and the detection rate was 92.5%.There was no statistical significance in the SLN detection rate of different injection sites, phases and tumor diameters(P>0.05).The SLN of endometrial carcinoma was mainly distributed in external iliac lymph nodes(32.4%, 46/142) and obturator lymph nodes(25.7%, 37/142).The sensitivity of nano carbon tracing SLN was 100%, and the negative predictive value was 100%.
ConclusionsThe technique of nano carbon tracing SLN in early endometrial carcinoma under laparoscopy is feasible, which provides an effective basis for the determination of lymph node metastasis and selection of surgical scope.

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