Nghiên cứu giá trị của sinh thiết hạch gác bằng xanh methylene trong điều trị ung thư nội mạc tử cung tại Bệnh viện Ung bướu Đà Nẵng

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Tác giả: Thị Ái Trinh Dương, Thị Hồng Ngọc Phan, Thị Như Quỳnh Trần, Tứ Quý Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 616.4 Diseases of hematopoietic, lymphatic, glandular systems Diseases of endocrine system

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 357-363

Bộ sưu tập: Metadata

ID: 500657

Thêm vào giỏ

Endometrial cancer is the most commonly diagnosed gynecological malignancy in Vietnam, after breast cancer. The primary treatment is based on surgical and pathologic staging including hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Sentinel lymph node (SLN) mapping for endometrial cancer (EC) is a contemporary technique that could provide benefits over traditional lymphadenectomy. The aim of this study was to describe the results of sentinel node biopsy, and analyze the factors that affect sentinel lymph node mapping. Materials and methods: We collected data from the first 31 cases of patients with endometrial cancer who underwent sentinel lymph nodes by using methylene blue from September 2019 to September 2021. We reported the detection rate and the accuracy of the SLN biopsy. Results: The overall detection rate of sentinel lymph node mapping of at least one site was included in 31 patients was 54.8%, bilateral sentinel node detection rate was 19.3%. The sensitivity and the specificity of the sentinel lymph node was 100%. The detection rate of sentinel lymph node in the first 20 cases was 40% and was 82% in the last 11 cases. Adoption of the SLN technique spared 34.1% hemi pelvic LND from a full lymphadenectomy. Conclusions: Sentinel lymph node sampling by using methylene blue is feasible and accurately predicts lymph node status in patients with endometrial cancer in low resource settings. There is a learning curve to the technique. SLN mapping was more successful after we have done 20 cases.Ung thư nội mạc tử cung là bệnh lý ác tính phụ khoa được chẩn đoán phổ biến nhất ở Việt Nam, sau ung thư vú. Phương pháp điều trị chủ yếu dựa trên phẫu thuật và giải phẫu bệnh bao gồm cắt tử cung hoàn toàn, phần phụ hai bên và nạo hạch vùng chậu. Sinh thiết hạch gác trong ung thư nội mạc tử cung là một kỹ thuật hiện đại có thể mang lại lợi ích so với phương pháp nạo hạch truyền thống. Mục đích của nghiên cứu này là mô tả kết quả và phân tích các yếu tố ảnh hưởng đến sinh thiết hạch gác. Phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang. Chúng tôi thu thập dữ liệu từ 31 trường hợp bệnh nhân ung thư nội mạc tử cung đầu tiên đã phẫu thuật sinh thiết hạch gác bằng xanh methylen từ tháng 9 năm 2019 đến tháng 9 năm 2021. Kết quả: Tỷ lệ phát hiện chung của hạch gác ở ít nhất một bên ở 31 bệnh nhân là 54,8%, tỷ lệ phát hiện hạch gác hai bên là 19,3%. Độ nhạy và độ đặc hiệu của hạch gác là 100%. Tỷ lệ phát hiện hạch gác trong 20 trường hợp đầu tiên là 40% và là 82% trong 11 trường hợp cuối cùng. Việc áp dụng kỹ thuật sinh thiết hạch gác đã giảm được 34,1% nạo hạch toàn bộ một bên. Kết luận: Sinh thiết hạch gác bằng xanh methylen là khả thi và dự đoán chính xác tình trạng hạch ở bệnh nhân ung thư nội mạc tử cung ở những nơi có nguồn lực hạn chế. Khả năng phát hiện thành công hạch gác cao hơn sau khi chúng tôi thực hiện 20 trường hợp.

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