- 作者：Hitoshi Niikura ; Michiko Kaiho-Sakuma ; Hideki Tokunaga ; Masafumi Toyoshima ; Hiroki Utsunomiya ; Satoru Nagase ; Tadao Takano ; Mika Watanabe ; Kiyoshi Ito ; Nobuo Yaegashi
- 关键词：Sentinel lymph node (SLN) ; Endometrial cancer ; 99mTc-phytate ; Micrometastasis ; Frozen section
- 刊名：Gynecologic Oncology
- 出版年：2013
- 出版时间：November, 2013
- 年：2013
- 卷：131
- 期：2
- 页码：299-303
- 全文大小：184 K
Objective
The aim of the present study was to clarify the most effective combination of injected tracer types and injection sites in order to detect sentinel lymph nodes (SLNs) in early endometrial cancer.Patients and methods
The study included 100 consecutive patients with endometrial cancer treated at Tohoku University Hospital between June 2001 and December 2012. The procedure for SLN identification entailed either radioisotope (RI) injection into the endometrium during hysteroscopy (55 cases) or direct RI injection into the uterine cervix (45 cases). A combination of blue dye injected into the uterine cervix or uterine body intraoperatively in addition to preoperative RI injection occurred in 69 of 100 cases. All detected SLNs were recorded according to the individual tracer and the resultant staging from this method was compared to the final pathology of lymph node metastases including para-aortic nodes.
Results
SLN detection rate was highest (96 % ) by cervical RI injection; however, no SLNs were detected in para-aortic area. Para-aortic SLNs were detected only by hysteroscopic RI injection (56 % ). All cases with pelvic lymph node metastases were detected by pelvic SLN biopsy. Isolated positive para-aortic lymph nodes were detected in 3 patients. Bilateral SLN detection rate was high (96 % ; 26 of 27 cases) by cervical RI injection combined with dye.
Conclusion
RI injection into the uterine cervix is highly sensitive in detection of SLN metastasis in early stage endometrial cancer. It is a useful and safe modality when combined with blue dye injection into the uterine body.