Preliminary Clinical Study Of Laparoscopic Sentinel Lymph Node Mapping Technique In Endometrial Carcinoma

Objective: The article was designed to analyze the detection rate and distribution of sentinel lymph node(SLN)in endometrial carcinoma(EC)and to analyze the accuracy of SLN in predicting retroperitoneal lymph nodes,and to explore the feasibility of SLN mapping technique in the treatment of EC,and to provide help for the accurate treatment of endometrial cancer patients.Methods: 66 cases of EC patients were collected from July 1,2015 to December 31,2016 at the Fourth Hospital of Hebei Medical University.All the patients were injected with methylene blue into the cervix at 3 and 9 points(2 points)or 5,7,2,and 11 points(4 points)in 5-10 minutes before the operation after anesthesia.All patients underwent SLN resection and then underwent laparoscopic systematic lymph node dissection.Moreover,all the lymph nodes resected were stained with hematoxylin eosin staining(HE)pathological examination.Besides,the identified SLNs were detected by HE pathological examination and immunohistochemistry cytokeratin staining(CK)micrometastasis.SPSS20.0 statistical software was applied.The detection rate and false negative rate were described.Enumeration data were analyzed by chi square test or Fisher exact probability method,and the consistency of Kappa test.P-values<0.05 were considered statistically significant.Results:1 The detection rate of SLN in EC was 100%,bilateral detection of SLN accounted for 97.0%(64/66),unilateral detection of SLN accounted for 3.0%(2/66),the accuracy rate was 100%,the false negative rate was 0,the negative predictive value was 100%.2 The total number of SLN in 66 cases EC was 427 pieces,accounting for 26.1%(427/1637)of the total lymph nodes,the average SLN per patient was 6.47 pieces,the average SLN per patient was 11.86 pieces less than None Sentinel Lymph Node(NSLN).3 Obturator area of EC SLN distribution was 53.2%(227/427),the external iliac23.7%(101/427),the internal iliac 7.7%(33/427),the common iliac 7.5%(32/427),parametrial area 0.5%(2/427),deep inguinal region 0.2%(1/427),para aortic left area 4.4%(19/427),the right vena cava area 1.9%(8/427),pre-sacral area 0.9%(4/427).4 The relationship between SLN and retroperitoneal lymph node metastasis in EC was analyzed.The kappa value was 1.000,P<0.001.5 Of the 66 cases of EC,3 cases(5 pieces)were detected lymph node metastasis,and both were pelvic SLN metastasis.One of the left external iliac SLN was confirmed to be micrometastasis by immunohistochemical CK micrometastasis.Conclusion:1 Methylene blue is a good SLN mapping tracer of EC,and Cervical site injection is a better way to identify SLN.SLN detection rate and negative predictive value are the key indexes to judge this technique.2 EC SLN is mainly located in the obturator area and the external iliac area.3 In this cohort,SLN mapping recognition technology is safe and feasible in the EC,and can be used in clinic.