早期子宫颈恶性肿瘤腹腔镜手术中两种示踪剂前哨淋巴结活检结果的对比分析

目的:通过在早期子宫颈恶性肿瘤患者中应用吲哚箐绿(ICG)及纳米炭混悬液为示踪剂行腹腔镜下前哨淋巴结(sentinel lymph node,SLN)切除术,对比两种示踪剂的示踪效果,寻找临床更适宜普遍使用的示踪剂。方法:选取仁济医院妇瘤科2016.8～2019.10期间诊断明确的122例早期子宫颈恶性肿瘤患者为研究对象。随机采用ICG或纳米炭为前哨示踪剂。对两种示踪剂的显影情况和SLN的示踪效果进行分析。结果:在122例子宫颈恶性肿瘤病例中,宫颈注射ICG64例,检出SLN385枚,平均每个患者检出6.02枚SLN,检出率100%(64/64),特异度96.77%,敏感度75%。宫颈注射纳米炭混悬液58例,检出SLN265枚,平均每个患者检出4.57枚SLN,检出率96.9%(56/58),特异度96.36%,敏感度66.67%。两种示踪剂都有较好的示踪效果(P=0.9356)。结论:早期子宫颈恶性肿瘤行宫颈注射ICG或纳米炭混悬液,腹腔镜下显影的SLN均具有较高的检出率与准确率,是一种较为可行的方法,可普遍开展,值得推广。

Comparative Analysis of Sentinel Lymph Node Biopsy with Two Tracers in Laparoscopic Surgery for Early-stage Cervical Cancer

ABSTRACT Objective: Laparoscopic sentinel lymph node (SLN) resection with indole green (ICG) and nano-carbon suspension as tracers was performed in patients with early-stage cervical cancer. The tracing effects of the two tracers were compared to find more suitable tracers for clinical use. Methods: 122 cases of early-stage cervical cancer diagnosed clearly in gynecological oncology department of Renji Hospital from 2016.8 to 2019.10 were selected as the research objects. Patients were randomly assigned to ICG or carbon nanoparticles as sentinel tracers. The development of two tracers and the tracing effect of sentinel lymph nodes were analyzed. Results: Of 122 cases of early-stage cervical cancer, 64 cases were injected with ICG and 385 SLNs were detected. On average, 6.02 SLNs were detected in each patient, the detection rate was 100%, and the false negative rate was 25%.In 58 cases of cervical injection of nano-carbon suspension, 265 SLNs were detected, with an average of 4.57 SLNs per patient, the detection rate being 96.9%, and the false negative rate being 33.33%. Both tracers have good tracing effect (P=0.9356). Conclusion: ICG or nano-carbon suspension injected into cervix of early-stage cervical cancer and SLN developed under laparoscopy have high detection rate and accuracy, which is a feasible method and can be widely carried out and worth popularizing.