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首页> 外文期刊>Journal of Gynecologic Oncology >Groin lymph node detection and sentinel lymph node biopsy in vulvar cancer
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Groin lymph node detection and sentinel lymph node biopsy in vulvar cancer

机译：外阴癌腹股沟淋巴结检测和前哨淋巴结活检

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Objective To identify suitable diagnostic tools and evaluate the efficacy of sentinel lymph node (SLN) biopsy for inguinal lymph node metastasis in vulvar cancer. Methods Data from 41 patients with vulvar cancer were evaluated retrospectively, including magnetic resonance imaging (MRI) measurements, SLN biopsy status, groin lymph node metastasis, and prognosis. Results SLN biopsy was conducted in 12 patients who had stage I to III disease. Groin lymphadenectomy was omitted in five of the nine patients with negative SLNs. All SLN-negative patients who did not undergo groin lymphadenectomy showed no evidence of disease after treatment. On MRI, the long and short diameters of the inguinal node were significantly longer in metastasis-positive cases, compared with negative cases, in 25 patients whose nodes were evaluated pathologically (long diameter, 12.8 mm vs. 8.8 mm, p=0.025; short diameter, 9.2 mm vs. 6.7 mm, p=0.041). The threshold of >10.0 mm for the long axis gave a sensitivity, specificity, positive predictive value, and negative predictive value of 87.5%, 70.6%, 58.3%, and 92.3%, respectively, using a binary classification test. Decision tree analysis revealed a sensitivity, specificity, and accuracy of 87.5%, 70.6%, and 76.0%, respectively, with the threshold of >10.0 mm for the long axis on MRI. The criteria of >10.0 mm for the long axis on MRI predicted an advanced stage and poorer prognosis using a validation set of 15 cases (p=0.028). Conclusion Minimally invasive surgery after preoperative evaluation on MRI and SLN biopsy is a feasible strategy for patients with vulvar cancer.
机译：目的确定合适的诊断工具并评估前哨淋巴结活检对外阴癌腹股沟淋巴结转移的疗效。方法回顾性分析41例外阴癌患者的数据，包括磁共振成像（MRI）测量，SLN活检状态，腹股沟淋巴结转移和预后。结果对12例I至III期疾病患者进行了SLN活检。 9例SLN阴性的患者中有5例省略了腹股沟淋巴结清扫术。所有未进行腹股沟淋巴结清扫术的SLN阴性患者在治疗后均未显示疾病迹象。在MRI上，在25例经淋巴结病理学检查的患者中，转移阳性的腹股沟淋巴结的长径和短径明显长于阴性病例（长径分别为12.8 mm和8.8 mm，p = 0.025;直径9.2毫米和6.7毫米，p = 0.041）。使用二元分类测试，长轴的阈值> 10.0 mm给出的敏感性，特异性，阳性预测值和阴性预测值分别为87.5％，70.6％，58.3％和92.3％。决策树分析显示，MRI长轴的敏感性，特异性和准确性分别为87.5％，70.6％和76.0％，阈值> 10.0 mm。 MRI长轴> 10.0 mm的标准使用一组15例验证病例预示了晚期阶段和较差的预后（p = 0.028）。结论术前评估MRI和SLN活检后的微创手术是治疗外阴癌的可行策略。

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