Clinical Significant Of Sentinel Lymph Nodes Detection In Patients With Early Stage Cervical Cancer Undergoing Radical Hysterectomy

Objective: To study the feasibility of sentinel lymph node (SLN) in patients with early stage cervical carcinoma undergoing radical hysterectomy and determine the significance of SLN in prediction of the pelvic lymph nodes status. Materials and Methods: From July 2003 to December 2003, twenty-two patients with cervical cancer at stage Ib1(n=12), stage Ib2(n=2)2, stage IIa (n=7), and stage IIb(n=1) underwent SLN detection by using blue dye (patent blue violet 1%). Four ml of patent blue violet 1% was injected into the cervix at 4 points around the tumor just at the time of radical hysterectomy and extensive biolateral pelvic lymphadenectomy. Tumor characteristics and specific locations of lymphatic dye uptake were recorded. The samples of SLNs and compared with pathology results and the SLNs also stained with anti-cytokeratin 17. Result: Out of 22 patients, SLNs were detected in 20 patients. A total of 57 SLNs were identified and the mean was 3 per patients . The detection rate of SLN was 91%. Sensitivity of the SLN was 91%, and specificity of SLN was 100%. Three patients (14%)were diagnosed with lymph node metastases and all these three patients are in the group of SLN. Two patients had both positive SLNs and pelvic lymph nodes. One patient had positive SLNs only. No one had positive pelvic lymph nodes and negative SLN nodes. The predictive rate was 100% and the false-negative rate was zero. Conclusion: SLN detection can successfully predict the pelvic lymph nodes status in patients with early cervical cancer, but the feasibility and safety of this technique to substitute conventional surgical modality should be further evaluated.