Laparoscopic Sentinel Lymph Nodes Biopsy in Patients with Early-Stage Cervical Cancer / 中国微创外科杂志

ABSTRACT

Objective To investigate the feasibility of sentinel lymph node(SLN) biopsy by laparoscopy in patients with early-stage cervical cancer,and its accuracy for predicting pelvic lymph nodes metastasis.Methods A total of 26 patients with early-stage cervical cancer were enrolled in this study.Laparoscopic bilateral pelvic lymphadenectomy and radical hysterectomy were carried out in all the cases.During the operation,4 ml of methylene blue dye(1%) were injected into the cervix at 4 sites around the tumor.Both the blue-dyed lymph nodes and the other resected tissues were removed for pathological examination by HE staining.The blue-dyed lymph node was considered as SLNs,and the pathological results of all the removed pelvic lymph nodes were set as a gold standard,based on which the accuracy and false-negative rate of SLN biopsy,as well as the distribution of the SLN were determined.Results Of the 26 cases,a total of 51 SLNs were found in 23 patients(88.5%),among which 6 patients had 1 SLN,9 had 2,6 had 3,1 had 4,and 1 had 5;65.2%(15) of the patients had bilateral SLN.Five of the 26 patients(19.2%) showed pelvic lymph nodes metastases.In the 23 patients diagnosed as having SLN,3 had metastases in the SLNs(totally 6 SLNs were involved,2 of the 3 cases had the metastasis both in the SLN and pelvic lymph nodes,the other had the metastasis only in the SLN).In one patient,the biopsy was negative in SLN,but positive in the pelvic lymph nodes.In this series,the accuracy,sensitivity,specificity and negative predictive value of SLN biopsy were 95.7%(22/23),75%(3/4),100%(19/19),and 95%(19/20),respectively.There was a correlation between SLNs and pelvic lymph nodes status(?=0.832).Conclusions It is feasible to accurately detect SLNs using laparoscopic SLNs biopsy in patients with early-stage cervical cancer.The method is capable of predicting the disease,as well as the metastasis of local lymph nodes.