早期卵巢癌症前哨淋巴结检测:N.N.Blokhin国家肿瘤医学研究中心的初步经验

M. Tikhonovskaya, A. S. Shevchuk
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引用次数: 0

摘要

背景。在临床早期上皮性卵巢癌患者中,建议进行手术分期,包括盆腔和主动脉旁淋巴结切除术。盆腔和腹主动脉旁淋巴结切除术的治疗作用仍存在争议,该手术可增加术中和术后并发症的风险。在早期卵巢癌中使用前哨淋巴结(SLN)检测非常有希望并降低手术损伤水平。但目前关于SLN的有效性、安全性、敏感性和特异性的资料有限,技术有待规范。目的探讨吲哚菁绿在早期卵巢癌SLN检测中的可行性。材料和方法。4例临床I期上皮性卵巢癌患者采用吲哚菁绿进行SLN检测。该示踪剂注射于卵巢门部或卵巢韧带残端。在红外光谱中检测到SLN。在SLN切除后,对盆腔和主动脉旁区进行全身腹膜后淋巴结清扫。本研究未进行冷冻切片。4例患者中3例在主动脉旁区检出SLN。所有患者均无转移性疾病。初步经验表明卵巢SLN定位是可行的。早期卵巢癌SLn检测的敏感性和特异性有待前瞻性研究评价。
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Sentinel lymph node detection in early stage ovarian cancer: the primary experience in N. N. Blokhin national medical Research Center of Oncology
Background. Surgical staging including pelvic and para-aortic lymphadenectomy is recommended in patients with clinical early-stage epithelial ovarian cancer. The therapeutic role of pelvic and para-aortic lymphadenectomy is still under debate, this procedure can increase risk of intra- and post-operative complications. using the sentinel lymph node (SLN) detection in early stage ovarian cancer in very promising and decreases the level of surgical damage. But nowadays the data on effectiveness, safety sensitivity and specificity of SLN are limited and the technique has to be standardized.Aim. To determine the feasibility of the SLN detection procedure using indocyanine green in early stage ovarian cancer.Materials and methods. four patients with clinical stage I epithelial ovarian cancer underwent SLN detection using indocyanine green. The tracer was injected into hilum of the ovary or ovarian ligament stumps in the case of previous adnexectomy. SLN were detected in infrared spectrum. Systemic retroperitoneal lymph node dissection of the pelvic and paraaortic areas was performed after SLN being removed. frozen section of was not performed in this study.Results. SLN were detected in paraaortic area in three of four patients. no one of patients had metastatic disease.Conclusion. The primary experience demonstrates SLN mapping of the ovary being feasible. Prospective study is required to evaluate sensitivity and specificity of SLn detection in early stage ovarian cancer.
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