中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (10): 944-948.doi: 10.19401/j.cnki.1007-3639.2021.10.011

• 综述 • 上一篇    下一篇

子宫内膜癌前哨淋巴结应用的研究进展与展望

鲁圆圆,杨 帆,郑 莹   

  1. 四川大学华西第二医院妇科,出生缺陷与相关妇儿疾病教育部重点实验室,四川 成都 610041
  • 出版日期:2021-10-30 发布日期:2021-11-10
  • 通信作者: 郑 莹 E-mail: zhy_chd@126.com
  • 基金资助:
    四川省科技厅重点研发项目(2020YFS0049);成都市科技局技术创新研发项目(2019-YF05-00473-SN)。

Research progress and prospect of sentinel lymph node mapping in endometrial carcinoma

LU Yuanyuan, YANG Fan, ZHENG Ying   

  1. Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan Province, China
  • Published:2021-10-30 Online:2021-11-10
  • Contact: ZHENG Ying E-mail: zhy_chd@126.com

摘要: 前哨淋巴结(sentinel lymph node,SLN)检测为子宫内膜癌患者的精准淋巴结切除提供了选择,极具应用前景,但仍有部分问题和争议亟待解决,如SLN检测在高危患者中的标准临床应用规范、SLN最佳算法、评估SLN的最佳方式、低体积转移的临床意义,均值得探究。目前子宫颈注射吲哚菁绿为最常用的示踪方法,病理学超分期可提高对低体积转移的检出率,但病理学超分期操作流程、应用指征及低体积转移的临床管理需进一步规范。此外,高危型子宫内膜癌并非SLN检测的绝对禁忌证,但此类患者行SLN检测的标准临床应用规范有待进一步研究。现就近年来子宫内膜癌SLN检测研究现状及进展进行综述。

关键词: 子宫内膜癌, 前哨淋巴结, 微转移, 病理学超分期

Abstract: Sentinel lymph node (SLN) mapping has been proposed as a more “targeted” alternative for accurate lymph node resection in endometrial cancer (EC). However, there are still some problems and disputes to be resolved. For example, the standard clinical application of SLN mapping in high-risk patients, the optimal SLN algorithm, the optimal approach to evaluate SLN and the clinical significance of low volume metastasis (LVM) are worth exploring. At present, the cervical indocyanine green injection is the most commonly used tracer method, and the detection rate of LVM can be improved by ultrastaging. However, the procedures and indications of ultrastaging and clinical management of LVM need to be further standardized. In addition, high-risk EC is not an absolute contraindication for SLN mapping, however, the standard clinical application of SLN mapping in such patients needs further clinical study. This article reviewed the research status and progress of SLN mapping in EC in recent years.

Key words: Endometrial cancer, Sentinel lymph node, Micrometastasis, Ultrastaging