国际妇产科学杂志 ›› 2020, Vol. 47 ›› Issue (6): 626-631.

• 综述 • 上一篇    下一篇

前哨淋巴结绘图在早期子宫内膜癌中的应用进展

翟莉蓉,谢洪影,张曦文,刘子玮,张丽颖,崔满华   

  1. 130041  长春,吉林大学第二医院妇产科(翟莉蓉,谢洪影,张曦文,刘子玮,崔满华);吉林大学(张丽颖)
  • 收稿日期:2020-05-08 修回日期:2020-08-31 出版日期:2020-12-15 发布日期:2020-12-11
  • 通讯作者: 崔满华,E-mail:cuimanhua@126.com E-mail:cuimanhua@126.com

The Application Progress of Sentinel Lymph Node Mapping in Early-Stage Endometrial Cancer

ZHAI Li-rong, XIE Hong-ying,ZHANG Xi-wen, LIU Zi-wei, ZHANG Li-ying, CUI Man-hua   

  1. Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130041, China(ZHAI Li-rong,XIE Hong-ying, ZHANG Xi-wen, LIU Zi-wei,CUI Man-hua); Jilin University, Changchun 130012, China(ZHANG Li-ying)
  • Received:2020-05-08 Revised:2020-08-31 Published:2020-12-15 Online:2020-12-11
  • Contact: CUI Man-hua, E-mail:cuimanhua@126.com E-mail:cuimanhua@126.com

摘要: 子宫内膜癌是妇科三大恶性肿瘤之一,其发病率逐年升高。以手术为主的综合治疗是其主要治疗原则,手术分期是确定子宫内膜癌患者病变范围、评估预后及选择辅助治疗的重要基础。常用的淋巴结分期策略包括系统性淋巴结切除术(LAD)及根据“梅奥标准”行选择性淋巴结切除术(SLAD),但LAD手术风险高,术后并发症多,其治疗意义与生存获益尚存争议。近年来,前哨淋巴结绘图(SLNM)逐渐成为子宫内膜癌手术分期的替代选择,通过切除少量高度相关淋巴结,可提供足够的信息指导手术病理分期及辅助治疗,同时最大程度减少手术损伤而不影响患者预后。综述SLNM在早期子宫内膜癌中的应用进展及相关争议,为临床子宫内膜癌患者手术分期及淋巴结评估的选择提供思路。

关键词: 前哨淋巴结;, 绘图;, 活组织检查;, 子宫内膜肿瘤;, 淋巴结切除术;, 超分期病理

Abstract: Endometrial cancer is one of the three main gynecologic malignancies and its incidence is increasing year by year. Surgery-based comprehensive treatment is its main treatment principle, and surgical staging is an important basis for determining the extent of disease, evaluating prognosis, and selecting adjuvant therapy in patients with endometrial cancer. Commonly used lymph node staging strategies include systemic lymphadenectomy (LAD) and selective lymphadenectomy (SLAD) according to the "Mayo criteria". However, LAD has higher surgical risks accompanying many postoperative complications and the survival benefit remains controversial. In recent years, sentinel lymph node mapping (SLNM) has gradually become an alternative to the staging of endometrial cancer. By removing a few highly relevant lymph nodes, it can provide sufficient information to guide surgical pathological staging and adjuvant treatment, while minimizing surgery injury without affecting the patients′ prognosis. This review aims to systematically analyze the progress and related controversies of SLNM in early-stage endometrial cancer, providing evidence for another treatment strategy in surgical staging and lymph node evaluation in endometrial cancer patients.

Key words: Sentinel lymph node, Drawings;, Biopsy;, Endometrial neoplasms;, Lymphnode excision;, Pathologic ultra-staging