Article Text
PDF
Abstract
Introduction Objective: To analyze the distribution, detection rate, false negative rate, sensitivity and negative predictive value of the Sentinel Lymph nodes (SLN) and explore the value of SLN mapping in predicting the LNs metastasis in ovarian cancer.
Methods It is a prospective single arm trial at one cancer center. 29 cases of ovarian cancer patients were enrolled from May 1, 2020 to Dec. 31, 2022. All the patients were injected with methylene blue into the ovarian cortex, uterine horns and infundibulopelvic ligaments by the same surgeon who once learned SLN mapping technique at Memorial Sloan-Kettering Cancer Center, SLNs biopsy was performed followed by systematic pelvic and para-aortic lymphadenectomy. The negative SLNs on HE staining were detected by immunohistochemistry cytokeratin staining (AE1/AE3) for low-valume metastasis.
Results The overall detection rate of SLN in ovarian cancer was 100% , sensitivity was 85.7%, false negative rate was 14.3%, and negative predictive value was 95.7%. The average of 31 LN and 9 SLNs were dissected for each person. SLN of ovarian cancer was mainly distributed in the supermensentric and inframensentric Para-cava(34.8%, 33.3%). 7 cases of LNs metastasis were found among all 29 cases, there were 12 SLNs metastasis and 45 NSLNs metastasis. 1 SLN was found to be isolated tumor cells (ITC). Metastatic SLNs mainly distributed in the Para-caval region(91.2%).25 cases were PDS and 9 were IDS.
Conclusion/Implications Intraoperative SLN mapping by injecting methylene blue is safe, feasible for predicting the LNs metastases, and pathological ultra-staging for SLNs could improved the detaction rate of LNs metastasis in ovarian cancer.
