宫颈癌前哨淋巴结研究新进展

宫颈癌淋巴结转移状态虽未纳入FIGO分期,但评价淋巴结是否转移不仅可以判断宫颈癌患者的预后,也可作为术后是否需要辅助治疗的依据。早期宫颈癌淋巴结转移率较低,系统淋巴结清扫导致的手术并发症是困扰临床医生的问题,前哨淋巴结活检技术有利于减少不必要的系统淋巴结清扫。该技术在宫颈癌中虽然已有十余年的研究积累,但由于各种原因仍未被临床广泛应用和接受。近几年宫颈癌新的应用策略的提出和新应用方向为宫颈癌前哨淋巴结的临床应用提供了新的契机,本文就宫颈癌前哨淋巴结应用策略新进展做一综述。

Update on sentinel lymph node evaluation in cervical cancer

The International Federation of Gynecology and Obstetrics(FIGO)staging system does not include lymph node status.But in surgically treated patients with early cervical cancer,lymph node metastasis is the most important risk factor for recurrence and death.Accurate knowledge of lymph node status is essential to tailor adjuvant treatment.In operable early stage cervical cancer,prevalence of lymph node metastasis is low.It suggests that majority of these patients may undergo lymphadenectmy for no direct benefit while being subjected to the potential risk of associated morbidities.Over the last decade,the use of sentinel lymph node(SLN)mapping procedure in cervical cancer has been studied by multiple groups in hundreds of patients.Nevertheless,it has not yet been adopted as a standard of care.Recently,two institutes developed different systematic algorithms for SLN mapping in cervical cancer with encouraging data from their studies.This review will focus on these algorithms which may give new approaches to apply SLN in cervical cancer lymph node status evaluation.