Reflection Of Sentinel Lymph Node-Clinical Research On 20 Cases Of Patients With Early Stage Cervical Cancer

Objective To study the distribution and transfer of sentinel lymph node(SLN) of the early cervical cancer pelvic outpost, in order to more deeply understand the relevant knowledge of pelvic lymph node excision. To discuss the clinical value of SLN for pelvic lymph node metastasis, so that to provide evidence for sentinel lymph node dissection replace systematic pelvic lymphadenectomy.Methods 20 patients with cervical cancer from Nov 2015 to Mar 2016 were detected sentinel lymph nodes(SLN) and non-sentinel lymph node(NSLN) by using methylene blue. And all the SLNs and NSLNs were taken pathological examination and analysis after pelvic lymphadenectomy.Results 1.20 patients of early stage cervical carcinoma were obtained 701 lymph nodes with an average of 35. A total of 115 SLNs were detected in all patients with an average of 6, the detection rate of SLN was 100%. 2. The sites of SLNs were spread over obturator(49 cases), internal iliac(32 cases), external iliac(15 cases), common iliac(13 cases) and groin(6cases), and the numbers of obturator SLNs and internal iliac SLNs were higher than those in other sites(P<0.05). 3. The comparison of lymph node positive rate was as follow.(1) Total positive rate of SLNs(8.7%) was higher than that of NSLNs(P<0.05).(2) The positive rate of SLNs on stageⅠB1(17.0%) was higher than that of NSLNs(P<0.05). The positive rate of SLNs and NLNs on stageⅠA2 and stage IB2 show no statistical significance(P>0.05).(3) The positive rates of SLNs on both squamous carcinoma and adenocarcinoma of cervix were higher than that of NSLNs(P<0.05). The same rate of SLNs on moderately differentiated of squamous carcinoma of cervix was higher than that of NSLNs(P<0.05). 4. The sensitivity of SLN in the diagnose of lymphatic metastasis was 80.0%, and specificity was 93.8%, false negative rate was 20.0%.Conclusion The metastasis of SLN was higher than that of the NSLN inearly cervical cancer, but there still exists misdiagnosis of SLN metastasis, which indicates systematic pelvic lymphadenectomy still cannot replace by sentinel lymph node dissection.