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背景与目的:阴茎癌在原发病灶切除后是否行腹股沟淋巴结清扫术一直存在争议,本文旨在探讨前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)在无肿大淋巴结的pN0期阴茎癌患者中的可行性及临床意义。方法:回顾性分析军事医学科学院附属医院泌尿外科2004年3月—2012年08月收治的25例pN0期阴茎癌患者的临床资料,切除原发病灶后均利用亚甲蓝蓝染,并同时行改良的腹股沟淋巴结清扫术(inguinallymph node dissection,ILND)。结果:前哨淋巴结(sentinel lymph node,SLN)实际检测出24例,成功率为96%(24/25),阳性7例,阴性17例;本组准确率为95.8%(23/24),灵敏度为87.5%(7/8),假阴性率为12.5%(1/8),无假阳性。SLNB病理结果与常规病理结果比较具有高度一致性(Kappa value=0.903,P<0.01)。结论:目前SLNB对于pN0期阴茎癌患者是否行淋巴结清扫术仍具有重要的的指导意义。
BACKGROUND & OBJECTIVE: It is a controversial topic whether or not the penile lymph node dissection is performed after the primary lesion has been excised. This article aims to investigate the clinical significance of sentinel lymph node biopsy (SLNB) in patients with penile cancer of pN0 without lymph nodes The feasibility and clinical significance. Methods: The clinical data of 25 patients with pN0 penile cancer who were admitted to the Department of Urology, Affiliated Hospital of Academy of Military Medical Sciences from March 2004 to August 2012 were retrospectively analyzed. After removal of the primary lesion, the cells were stained with methylene blue, Improved inguinal lymph node dissection (ILND). Results: 24 cases were detected in sentinel lymph node (SLN), the success rate was 96% (24/25), 7 cases were positive and 17 cases were negative. The accuracy of this group was 95.8% (23/24), the sensitivity Was 87.5% (7/8), the false negative rate was 12.5% (1/8), no false positive. The pathological results of SLNB were highly consistent with the results of routine pathology (Kappa value = 0.903, P <0.01). Conclusion: The current SLNB for pN0 penile cancer patients with lymph node dissection is still an important guide.