Identification of the sentinel lymph node in cervical cancer / Identificação de linfonodo sentinela em cancer do colo uterino

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Objectives: To evaluate sentinel lymph node detection in cervical cancer patients using a combination of patent blue dye and technetium99m and assess complications associated with the use of patent blue dye. Subjects and methods: This study investigated a case series that selected 56 women diagnosed with FIGO stage Ia2, Ib1, Ib2 and IIa cervical cancer who underwent a procedure for sentinel lymph node identification. The study was conducted from May 2006 to December 2007 and was described in two articles. The first article was about a study of sentinel lymph node detection in cervical cancer using a combination of patent blue dye and technetium99m. It assessed the agreement between preoperative lymphoscintigraphy and intraoperative lymphatic mapping with a gamma probe. The second article focused on the evaluation of changes in pulse oximetry readings in patients undergoing surgery after patent blue injection. Results: In the first article, at least one sentinel lymph node was identified in 83.13% of the patients and the most frequent site for finding sentinel lymph nodes was the external iliac chain. The sensitivity, specificity, positive predictive value and negative predictive value were 80%, 100%, 100% and 97.67% respectively on histopathology examination of frozen biopsy. In addition, it was observed that preoperative lymphoscintigraphy detected a substantially lower number of sentinel lymph nodes when compared to intraoperative lymphatic mapping with a gamma probe. In the second study, only one patient presented with an anaphylactic reaction. Thirteen patients showed a decrease in pulse oximetry readings (less than 96% saturation) after patent blue injection into the cervix, which lasted an average of five minutes and had no clinical repercussions. There was a borderline association between this decline in oxygen saturation values and tumors that were larger and located around the external cervical os. Conclusions: It was concluded that a combination of patent blue dye and technetium99m demonstrated excellent results in the detection of sentinel lymph nodes. Preoperative lymphoscintigraphy offers no advantage in relation to intraoperative lymphatic mapping with patent blue dye and technetium99m. There were no clinical repercussions due to lower oxygen saturation values. These changes correlated with tumors that were larger and located around the external cervical os, although the significance of this correlation was borderline

ASSUNTO(S)

biopsy cervix uteri colo uterino sentinel lymph node ganglios linfaticos - biópsia lymph nodes linfonodos biopsia biopsia de linfonodo sentinela uterine cervix neoplasms lymph cancer do colo uterino nodus lymphaticus biopsy

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