前哨淋巴结切除术在外阴癌中的研究进展及 争议

Research Progress and Controversies of Sentinel Lymph Node Biopsy in Vulvar Cancer

摘要: 外阴癌(Vulvar cancer, VC)是一种罕见的妇科恶性肿瘤，近年来发病率呈上升趋势。淋巴结状态是影响外阴癌预后最重要的独立危险因素。传统的腹股沟淋巴结清扫术虽然能准确评估淋巴结状态，但术后并发症发生率较高。前哨淋巴结活检技术(Sentinel Lymph Node Biopsy, SLNB)通过识别并切除肿瘤淋巴引流的第一站淋巴结，可在评估淋巴结状态的同时降低手术并发症。本文系统回顾了前哨淋巴结切除术在外阴癌中的应用研究进展，从外阴淋巴引流的解剖基础、示踪技术演变、适应证与争议等方面进行综述，为临床实践提供参考。

Abstract: Vulvar cancer is a rare gynecological malignancy with an increasing incidence in recent years. Lymph node status is the most important independent prognostic factor for vulvar cancer. Although traditional inguinofemoral lymphadenectomy can accurately evaluate lymph node status, it is associated with a high incidence of postoperative complications. Sentinel lymph node biopsy (SLNB), which identifies and removes the first lymph node station in tumor lymphatic drainage, allows for accurate lymph node staging while reducing surgical morbidity. This review systematically summarizes the research progress of SLNB in vulvar cancer, covering the anatomical basis of vulvar lymphatic drainage, the evolution of tracer techniques, clinical indications, and current controversies. The aim is to provide a reference for clinical practice.