亚甲蓝检测阴茎癌前哨淋巴结在腹股沟淋巴结清扫中的意义

目的:探讨亚甲蓝检测阴茎癌前哨淋巴结(SN)在腹股沟淋巴结清扫中的意义。方法:22例阴茎癌患者采取阴茎原发病灶切除同时,采用亚甲蓝检测腹股沟SN作活检,并选择SN转移病例及时行该侧腹股沟区淋巴结清扫术,计算该方法的准确度,假阴性率。结果:95%(21/22)的患者术中可检测到SN,19例患者两侧均可检测到SN,2例为单侧。21例患者中40枚SN,其中阳性淋巴结11例(27.5%)。4例腹股沟SN阴性患者在随访中出现腹股沟淋巴结或盆腔淋巴结转移。亚甲蓝在检查阴茎癌SN阳性预测率100%,准确度81%,其中假阴性率28%。结论:本方法术前准备简单,操作方便,费用较低,可作为一种经济有效的检测方式。

Clinical significance of methylene blue technique in sentinel node biopsy of penile carcinoma

Objective： To evaluate clinical significance of methylene blue technique in sentinel node biopsy （SNB） of penile carcinoma. Method： Twenty-two patients diagnosed penile carcinoma underwent lymphatic mapping with methylene blue and SNB. The patients whose sentinel nodes （SNs） turned to be positive accepted inguinal lymph node dissection. We calculated the accuracy and false-negative rate. Result.. SNs were identified in 95% of the patients （21/22）. Nineteen patients were identified bilaterally and two patients were identified unilaterally. Forty SNs were identified in 21 patients, of which, 11 were positive （27.5%）. Four patients were found inguinal or pelvic lymph node metastasis at the follow-up period. The data showed that positive predictive value was 100%, overall accuracy was 81% and false-negative rate was 28%. Conclusion： SNB using methylene blue for penile carcinoma is an easy-to-operate, effective and economic technique.