Sentinel lymph node detection using methylene blue in patients with early stage cervical cancer

被引:32
作者
Zhang, Hui-Zhong
Yuan, Song-Hua
Xiong, Ying
Wei, Mei
Yan, Xiao-Jian
Zhang, Hui-Zhong
Zeng, Yi-Xin
Liang, Li-Zhi [1 ]
机构
[1] Sun Yat Sen Univ, Dept Gynecol Oncol, Ctr Canc, State Key Lab Oncol So China, Guangzhou, Peoples R China
[2] Sun Yat Sen Univ, Dept Expt Res, Ctr Canc, State Key Lab Oncol So China, Guangzhou, Peoples R China
[3] Guangzhou Univ Chinese Med, Affiliated Hosp 2, Dept Gynecol, Guangzhou, Peoples R China
关键词
cervical carcinoma; sentinel lymph node; methylene blue; radical abdominal hysterectomy;
D O I
10.1016/j.ygyno.2007.03.037
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective. To evaluate the feasibility of sentinel lymph node (SLN) detection in patients with cervical cancer using the low-cost methylene blue dye and to optimize the application procedure. Patients and methods. Patients with stage Ib(1)-Il(a) cervical cancer and subjected to abdominal radical abdominal hysterectomy and pelvic lymphadenectomy were enrolled. Methylene blue, 2-4 ml, was injected into the cervical peritumoral area in 77 cases (4 in] patent blue in the other four cases) 10-360 min before the incision, and Surgically removed lymph nodes were examined for the blue lymph nodes that were considered as SLNs. Results. High SLN detection rate was successfully achieved when 4 ml of methylene blue was applied (93.9%, 46/49). Bilaterally SLN detection rate was significantly higher (78.1% vs. 47.1% P=0.027) in cases when the timing of application was more than 60 min before surgery than those with timing no more than 30 min. The blue color of methylene blue-stained SLNs sustained both in vivo and ex vivo, compared with the gradually faded blue color of patent blue that detected in 3 of 4 cases unilaterally. In the total of 112 dissected sides, the most common location of SLNs was the obturator basin (65.2%, 73/112), followed by external iliac area (30.4%, 34/112) and internal iliac area (26.8%, 30/112). Three patients who gave false negative results all had enlarged nodes. Conclusion. Methylene blue is ail effective tracer to detect SLNs in patients with early stage cervical cancer. The ideal dose and timing of methylene blue application are 4 ml and 60-90 min prior surgery, respectively. (c) 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:147 / 152
页数:6
相关论文
共 37 条
[1]   Role of sentinel lymph node biopsy procedure in cervical cancer: a critical point of view [J].
Angioli, R ;
Palaia, I ;
Cipriani, C ;
Muzii, L ;
Calcagno, M ;
Gullotta, G ;
Panici, PB .
GYNECOLOGIC ONCOLOGY, 2005, 96 (02) :504-509
[2]   Value of intraoperative imprint cytology of sentinel nodes in patients with cervical cancer [J].
Barranger, E ;
Cortez, A ;
Uzan, S ;
Callard, P ;
Darai, E .
GYNECOLOGIC ONCOLOGY, 2004, 94 (01) :175-180
[3]   Laparoscopic detection of sentinel lymph nodes followed by lymph node dissection in patients with early stage cervical cancer [J].
Buist, MR ;
Pijpers, RJ ;
van Lingen, A ;
van Diest, PJ ;
Dijkstra, J ;
Kenemans, P ;
Verheijen, RHM .
GYNECOLOGIC ONCOLOGY, 2003, 90 (02) :290-296
[4]   Laparoscopic assessment of the sentinel lymph node in early stage cervical cancer [J].
Dargent, D ;
Martin, X ;
Mathevet, P .
GYNECOLOGIC ONCOLOGY, 2000, 79 (03) :411-415
[5]   Laparoscopic assessment of the sentinel lymph nodes in early cervical cancer. Technique-preliminary results and future developments [J].
Dargent, D ;
Enria, R .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2003, 48 (03) :305-310
[6]   Total laparoscopic radical hysterectomy with intraoperative sentinel node identification in patients with early invasive cervical cancer [J].
Gil-Moreno, A ;
Díaz-Feijoo, B ;
Roca, I ;
Puig, O ;
Pérez-Benavente, MA ;
Aguilar, I ;
Martínez-Palones, JM ;
Xercavins, J .
GYNECOLOGIC ONCOLOGY, 2005, 96 (01) :187-193
[7]   LYMPHATIC MAPPING AND SENTINEL LYMPHADENECTOMY FOR BREAST-CANCER [J].
GIULIANO, AE ;
KIRGAN, DM ;
GUENTHER, JM ;
MORTON, DL .
ANNALS OF SURGERY, 1994, 220 (03) :391-401
[8]  
Ikeda Tadashi, 2004, Asian J Surg, V27, P275, DOI 10.1016/S1015-9584(09)60050-6
[9]   Laparoscopic sentinel lymph node detection in patients with cervical cancer [J].
Kamprath, S ;
Possover, M ;
Schneider, A .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2000, 182 (06) :1648-1648
[10]   Laparoscopic identification of sentinel lymph nodes in early stage cervical cancer - Prospective study using a combination of patent blue dye injection and technetium radiocolloid injection [J].
Lambaudie, E ;
Collinet, P ;
Narducci, F ;
Sonoda, Y ;
Papageorgiou, T ;
Carpentier, P ;
Leblanc, E ;
Querleu, D .
GYNECOLOGIC ONCOLOGY, 2003, 89 (01) :84-87