| ObjectiveCarbon nanoparticles suspension tracer method was used to determine and obtain SLN, and exploring SLN distribution law.Detection of miRNA-155 expression in SLN by Q-PCR,confirm clinical value of miRNA-155 in SLN micrometastasis of endometrial carcinoma.Objective to investigate the accuracy of Carbon nanoparticles suspension in the application of sentinel lymph node mapping in endometrial carcinoma, to provide a strong basis for retroperitoneal lymph node dissection.Methods1.To Collect 96 cases that used Carbon nanoparticles suspension to track the SLN of endometrial carcinoma patients in the Department of Gynecologic Oncology in Third Affiliated Hospital of Kunming Medical University from March 2014 to March 2016.All the patients had by subradical/extensive hysterectomy+retroperitoneal lymph node dissection + double accessory resection, to investigate the distribution of SLN in endometrial carcinoma, and whether SLN can indicate the retroperitoneal lymph node metastasis in endometrial carcinoma.2.To Collect 42 cases that used Carbon nanoparticles suspension to track the SLN of endometrial carcinoma patients in the Department of Gynecologic Oncology in Third Affiliated Hospital of Kunming Medical University from Spring 2015 to March 2016.A11 the patients had by subradical/extensive hysterectomy+retroperitoneal lymph node dissection + double accessory resection.The expression level of miRNA-155 was detected by real-time quantitative reverse transcription polymerase chain reaction in all SLN samples collected from endometrial carcinoma,compared the expression level of miRNA-155 in endometrial carcinoma SLN and normal endometrium,then the relationship between the expression and clinicopathological factors was analyzed.Results1.The detection rate of SLN : In 96 cases,SLN is successfully detected in 73 cases(76.04%) ; 37 cases of cervical injection , successfully detected in 27 cases(72.97%) ; 59 cases of intrauterine injection,successfully detected in 46 cases(77.97%).2.The distribution of SLN in 73 cases of successful,according to the difference of carbon nanoparticles suspension site: a.Cervical injection : external Iliac area 47.9%(46/96) , obturator area 30.2% (29/96) , Iliac area 11.5% (11/96) , abdominal aorta area 6.25% (6/96),internal Iliac area 3.13% (3/96) , parametrial area 1.04%(1/96) ; b.Uterine body injection: external Iliac area 37.28% (63/169) , obturator area 35.5% (60/169) , abdominal aorta area 10.65% (18/169) , Iliac area 10.65%(18/169) , internal Iliac area 4.14% (7/169) , presacral area 1.18% (2/169),parametrial area 0.59% (1/169).3.In 96 cases,and lymph node metastasis was confirmed by pathology in 11 cases(11.46%) .5 cases were found positive SLN, another 5 cases had positive lymph nodes,another 1 cases of SLN were false negative.The sensitivity of SLN detection was 45.46% (5/11) , the specificity was 100% (85/85) , the accuracy was 93.75%(90/96) , the false negative rate was9.09% (1/11) , the negative predictive value was 93.41% (85/91).4.The expression level of miRNA-155:The expression level of miRNA-155 in the endometrial carcinoma SLN with pathological metastasis is(5.9017±3.09206),the SLN without metastasis is(1.0283±0.90775),the difference was statistically significant (P<0.01);the expression of miRNA-155 in endometrial carcinoma tissues is(2.7297±2.06995), compared with the normal endometrium, the difference was statistically significant (P < 0.05) ; the expression of miRNA-155 in normal endometrium is (0.6237±0.50646),compared with the pathology without metastasis,the difference was not statistically significant (P>0.05).5.103 SLN samples are obtained from 42 endometrial carcinoma cases,12 of them were positive, the positive rate of SLN is 11.65%(12/103), the positive rate of SLN was detected by Q-PCR method is 33.01%(34/103).91 negative lymph nodes,22 positive expression rate is 24.18%(22/91).Both comparison that the difference was statistically significant (P<0.01).6.The positive expression rate of miRNA-155 in the experimental group was not correlated with age, tumor diameter,tumor differentiation and myometrial invasion depth (P>0.05) , closely correlated with tumor type , FIGO stage and lymph node metastasis (P< 0.05).Conclusions1 .It is feasible to use the carbon nanoparticles suspension to identify SLN in endometrial carcinoma, and it can be used as a safe and effective lymphatic tracer.2.There was no significant difference in the detection rate of SLN in cervical carcinoma with cervical and uterine body injection, and there is no obvious difference between different stratification factors.3.The distribution of endometrial carcinoma SLN is mainly external Iliac area,obturator area, Iliac area and abdominal aorta area.4.The status of SLN in patients with early endometrial carcinoma can effectively predict the status of pelvic retroperitoneal lymph node metastasis.5.The expression level of miRNA-155 in the early stage of endometrial carcino ma was significantly higher than in normal endometrium and SLN without met astasis,and the positive expression rate of miRNA-155 was closely correlated w ith tumor type , FIGO stage and lymph node metastasis,it may improve the de tection rate of micrometastasis in SLN. |
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