子宫内膜癌前哨淋巴结显影的初步研究

目的探讨在子宫内膜癌盆腔淋巴结切除术中进行前哨淋巴结（SLN）识别的可行性。方法选择接受手术治疗的临床Ⅰ、Ⅱ期子宫内膜癌患者18例。术中将示踪剂亚甲蓝分多点注射于子宫浆膜下,追踪识别最先蓝染的淋巴结为SLN。随后行子宫切除及盆腔淋巴结清扫术。结果 18例均有子宫浆膜面及双侧骨盆漏斗韧带内的淋巴管着色,其中16例（88.9%）盆腔内淋巴管同时着色;13例识别出SLN,共计47枚,平均每例3.6枚（1～7枚）,识别率为72.22%（13/18）。有2例患者发生淋巴结转移,皆有SLN显示,且SLE皆有转移检出,准确性为100%（13/13）,假阴性率为0。未发现与本研究相关的损伤及不良反应。结论应用亚甲蓝在子宫内膜癌术中进行SLN识别具有可行性,此技术简便、安全,但还需要大量的临床研究进一步证实。

The preliminary research of sentinel lymph node enhancement identification detection in endometrial cancer

Objective To evaluate the feasibility of intraoperative detection of sentinel lymph nodes（SLN） in patients with endometrial cancer.Methods Eighteen patients with clinical stage I-II endometrial cancer treated with operation were enrolled in the study.Methylene blue dye was injected into the subserosal myometrium of corpus uteriat at the time of hysterectomy and bilateral pelvic lymphadenectomy.Blue nodes identified as SLNs were excised.Results Blue dye diffusing to the lymphatic channels in the uterine surface and infundibulopelvic ligaments was seen in all cases.Among those cases,blue dye taken up into pelvic lymphatic vessels was observed in 16（88.9%） patients.The SLNs were identified in 13 cases,the SLNS were successfully detected in 72.2% %（13/18）;A total of 47 SLNs with a mean number of 3.6 SLNs（range,1-7）.Two patients had nodal metastases and had involvement with at least 1 SLN.accuracy was 100 %（13/13）,fake negative rate was 0.No adverse reactions or injuries were attributed to the study.Conclusion Intraoperative SLN identification with methylene blue dye in endometrial cancer is feasible and safe.