目的 探讨腹腔镜下应用纳米炭示踪剂检测前哨淋巴结(SLN)在早期宫颈癌中应用的可行性及价值.方法 选取21例确诊的早期宫颈癌患者,术前从宫颈注射纳米炭混悬注射液,腹腔镜直视下识别黑染淋巴结作为SLN并切取,随后均行腹腔镜下盆腔淋巴结清扫术+广泛全子宫切除(+腹主动脉旁淋巴结取样术),所有标本分装后送常规病检.结果 21例中20例成功检出至少1枚SLN,检出率为95.24%(20/21),共检出158枚SLN,平均每例每侧3.9枚SLN.5例(23.81%)患者共检出16枚阳性淋巴结,其中包括4例患者的14枚(87.50%)阳性SLN.SLN检测的灵敏度为80.0%(4/5),准确性为100.0%(20/20),阴性预测值为100.0%(16/16).结论 闭孔为早期宫颈癌SLN检出频次最高的淋巴引流区域,早期宫颈癌SLN的转移状态同盆腔淋巴结真实转移状态一致性较高,具有较为准确的病理代表意义,腹腔镜下应用纳米炭示踪早期宫颈癌SLN的检测是一种较为安全可行的方法.%Objective To explore the role of laparoscopic sentinel lymph node ( SLN) detection with carbon nanoparticles tracer in cervical carcinoma Methods Totally 21 patients with confirmed early cervical cancer were enrolled in this study. Before laparoscopic extended hysterectomy and pelvic lymphadenoetomy (and para-aortic lymphadenoectomy) , they were injected with carbon nanoparticles suspension injection tracer from cervical neck before surgery. The black-staining lymph nodes were cut as SLN under the laparoscope for routine pathological examination. Results Of these 21 patients, at least one SLN was successfully detected in 20 patients (95.24% ) , and a total of 158 SLNs were detected. The conventional pathology results suggested that 5 patients (23. 81% ) had positive lymph nodes ( n = 16 , including 14 in 4 patients). The new approach showed a sensitivity of 80. 0% ( 4/5 ) , accuracy of 100. 0% ( 20/20 ) , and negative predictive value of 100.0% (16/16) for SLN detection. Conclusion Laparoscopic SLN detection with carbon nanoparticles tracer is a relative safe and sensitive method for in cervical carcinoma.
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