宫颈癌和子宫内膜癌诊疗中盆腔淋巴结状态的检测及意义

淋巴结转移作为宫颈癌和子宫内膜癌的主要转移途径，是影响其预后的重要因素。在治疗前和治疗过程中如何检测和评估这2种恶性肿瘤的盆腔淋巴结状态仍处于初步探索阶段。目前检测淋巴结状态的方法有超声检查、计算机断层扫描、磁共振成像（MRI）、正电子发射计算机断层显像（PET-CT）和前哨淋巴结活检定位等。不同检查方法的原理不同，其敏感度、特异度和准确度等方面各有优劣。随着影像学技术及显像生物制剂的发展，淋巴结状态检测已由单纯形态学向功能学转变。彩色多普勒超声、弥散加权成像及PET-CT等均在传统影像学技术上进一步提高了敏感度和特异度，其中PET-CT和功能性MRI在检测的敏感度、特异度和准确度等方面尤其具有优势；显像生物制剂通过不断发展，已逐渐细化为针对淋巴结内肿瘤细胞代谢、血管和淋巴回流等三方面的特异性淋巴造影剂。

The Detection and Significance of Pelvic Lymph Node Status in Diagnosis and Treatment of Cervical Cancer and Endometrial Carcinoma

Lymph node metastasis as the main route of metastasis of cervical cancer and endometrial cancer, and is an important factor affecting the prognosis of cervical cancer and endometrial cancer. The way how to detect and evaluate the lymph node status before and during the therapy has still been in the preliminary exploration. Current methods of detecting lymph node status are ultrasonography, computer tomography, magnetic resonance imaging (MRI), positron emission tomography/computer tomography (PET-CT) and localization by sentinel lymph node biopsy etc. Different methods create images in different ways and have different sensitivity, specificity and accuracy. With the development of radiological technology and the imaging agents, the detection levels of lymph node status have been developed from simple morphology to function. Color Doppler ultrasonography, diffusion-weighted imaging, PET-CT. etc are more sensitive and specific when compared with traditional methods. Among them, PET-CT and functional MRI imaging have advantages in the detection of sensitivity, specificity and accuracy. Imaging agents are subdivided into three kinds of agents detecting tumor cell metabolism, vessel and lymphatic drainage through development.