[Sentinel lymph node detection and intra-operational diagnosis in patients with early stage cervical cancer].
OBJECTIVE
To study the effective method for rapid detection of sentinel lymph nodes in patients with early stage cervical cancer and clinical value thereof.


METHODS
Thirty female patients with early stage cervical cancer, 14 at FIGO stage IB1 and 16 at stage IIA, underwent injection of 99mTc-labelled sulfur colloid 0.4 mci/0.4 ml at the positions of 3, 6, 9, and 12 o'clock of the cervix 5 h or 18 h before operation, and injection of 1 ml of methylene blue at the same cervical positions as mentioned above after the abdomen was opened. The blue-stained lymph nodes or the lymph nodes directed by the blue-stained lymph vessels were identified as SLNs: gamma-detector was used to position the hot nodes. The SLNs were resected and then radical hysterectomy and pelvic lymphadenectomy were performed. SLN frozen section and imprint cytology were conducted during the operation, the results were compared with that of HE staining


RESULTS
SLN were detected successfully in 29 of the 30 patients with a detection rate of 96.7%. Routine HE staining indicated pelvic lymph node metastasis in 9 patients. The SLN was positive in 8 of the 29 patients, negative in 20 patients, and false negative in 1 patient. The sensitivity, accuracy, and false-negative rates of SLN detection were 88.9%, 96.6%, and 11.1% respectively. The sensitivity, specificity, accuracy, and positive and negative predictive rates were 92.3%, 100%, 98.9%, 100%, and 98.8% for frozen section, and 92.3%, 97.6%, 96.8%, 85.7%, and 98.8% for imprint cytology respectively.


CONCLUSIONS
Frozen section and imprint cytology may be effective rapid methods to diagnose SLN metastasis during operation. SLN detection can predict pelvic lymph node metastasis in cervical cancer.
Lou
Han-Mei
HM
Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
Lü
Wei-Guo
WG
Xie
Xing
X
Yang
Zheng-Yan
ZY
Ying
Ye
Y
Xiao
Bi-Wen
BW
Fang
Xian-Hua
XH
D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology* / Q000601:surgery; D016616:Cryoultramicrotomy; D005260:Female; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery