前哨淋巴结活检在高危子宫内膜癌中的应用进展

Advances in the Application of Sentinel Lymph Node Biopsy in High-Risk Endometrial Cancer

摘要: 子宫内膜癌作为危害女性健康的一个重要因素，除了癌症本身对女性健康的影响，手术过程以及术后并发症，都成为影响患者术后生活质量的重要因素，其中系统性淋巴结清扫术作为影响术后生活质量的一个原因，成为了关注点。前哨淋巴结活检作为替代系统性淋巴结清扫术的方案，一方面可以降低术中及术后的并发症发生率，另一方面，可以进行病理超分期，发现更小的病变，如孤立肿瘤细胞和微转移，以指导进一步治疗。前哨淋巴结活检的示踪剂及其注射部位有着较多的探索和研究，常用的示踪剂有吲哚菁绿等，注射部位则包括子宫颈注射及多个部位联合注射等。病理超分期也不局限于传统的伊红苏木精染色联合免疫组化，出现了基于分子检测的一步核酸扩增等方法，以提高检测的速度和准确性。依照前哨淋巴结算法，前哨淋巴结活检在低危子宫内膜癌中有着良好的前景，而对于高危子宫内膜癌，仍需要更多的研究明确其可行性。

Abstract: Endometrial cancer has a huge effect on women’s health. In addition to the impact of cancer itself on women’s health, the surgical process and postoperative complications have become important factors affecting patients’ postoperative quality of life. Systematic lymphadenectomy has become a focus as a reason for affecting the quality of life after surgery. Sentinel lymph node biopsy, as an alternative to systematic lymphadenectomy, can reduce the incidence of complications during and after surgery, and on the other hand, it can be used for pathological ultra-staging to find smaller lesions, such as isolated tumor cells and micrometastasis, to guide further treatment. There are many explorations and researches on the tracers of sentinel lymph node biopsy and their injection sites. The commonly used tracers include indocyanine green, and the injection sites include cervical injection and joint injection of multiple sites. Pathological ultra-staging is not limited to the traditional eosin hematoxylin staining combined with immunohistochemistry, and there are one-step nucleic acid amplification methods based on molecular detection to improve the speed and accuracy of detection. According to the sentinel lymph node algorithm, sentinel lymph node biopsy has a good prospect in low-risk endometrial cancer, but for high-risk endometrial cancer, more research is still needed to clarify its feasibility.