Buscar en
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
Toda la web
Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Selective biopsy of the sentinel node in cancer of cervix: Experience in validat...
Journal Information
Vol. 37. Issue 6.
Pages 359-365 (November - December 2018)
Share
Share
Download PDF
More article options
ePub
Visits
2
Vol. 37. Issue 6.
Pages 359-365 (November - December 2018)
Original Article
Selective biopsy of the sentinel node in cancer of cervix: Experience in validation phase
Biopsia selectiva del ganglio centinela en cáncer de cérvix: experiencia en fase de validación
Visits
...
J. Cea Garcíaa,
Corresponding author
jor_cea@hotmail.com

Corresponding author.
, P.A. de la Riva Pérezb, I. Rodríguez Jiméneza, F. Márquez Maravera, A. Polo Velascoa, J. Jiménez Gallardoa, M.V. Aguilar Martína, T. Cambil Molinab, M.N. Cabezas Palaciosa
a Unidad de Gestión Clínica Obstetricia y Ginecología, Hospital Universitario Virgen Macarena, Sevilla, Spain
b Unidad de Gestión Clínica, Radiodiagnóstico y Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (3)
Table 1. Number of sentinel lymph nodes (SLN) detected per patient by SPECT/CT.
Table 2. Sentinel lymph nodes (SLN) detected per patient by SPECT/CT and laparoscopy.
Table 3. Contingency table showing the results of the validation.
Show moreShow less
Abstract
Background and objective

Sentinel lymph node biopsy (SLNB) was created to reduce the morbidity associated with pelvic lymphadenectomy in the early stages of cervical cancer (CC), preserving its prognostic information. The goal is to assess the diagnostic validity of SLNB in CC in initial stages (IA1 with lymphovascular infiltration (LVI)+, IA2, IB1 and IIA1), thus avoiding unnecessary lymphadenectomies in many of the cases.

Material and method

From January 2012 to April 2017, 23 patients with initial stages of CC were included in a cross-sectional study to evaluate the effectiveness of the SLNB in CC with a mixed technique of cervical injection of 99mTc-nanocolloid of albumin and methylene blue, using combined planar lymphoscintigraphy with multimodality SPECT/CT image and subsequent removal of the sentinel node (SN) by laparoscopy.

Results

The detection rate of SLNB with the mixed technique was 95.65%, with a negative predictive value (NPV) of 95.45% and sensitivity (S) of 100% in the case of bilateral drainage. The mean of excised SN was 3 (range 1–5). The bilateral detection rate in laparoscopy was 85.35%. The concordance between SPECT/CT and laparoscopy for the number and bilaterality of the SN using the Pearson coefficient was r=0.727 and r=0.833, respectively; p=0.01. We only found one SN with a deferred result of micrometastasis and one false negative was detected.

Conclusions

SLNB in CC using a mixed technique has a high detection and bilateral drainage rate, but S is still low if we include cases of unilateral drainage. A greater number of cases and the development of intraoperative ultrastaging could increase the S of the technique and to reduce the number of false negatives.

Keywords:
Sentinel lymph node biopsy
Methylene blue
99mTc-nanocolloid
Laparoscopy
Uterine cervical neoplasms
Resumen
Antecedentes y objetivo

La biopsia selectiva del ganglio centinela (BSGC) surgió para disminuir la morbilidad asociada a la linfadenectomía pélvica en estadios iniciales del cáncer cervical (CC), conservando la información pronóstica obtenida de ella. El objetivo es determinar la validez diagnóstica de la BSGC en CC en estadios iniciales (IA1 con infiltración linfovascular [ILV]+, IA2, IB1 y IIA1), evitando así linfadenectomías innecesarias en muchos de los casos.

Material y método

Desde enero del 2012 hasta abril del 2017, 23 pacientes con estadios iniciales de CC fueron incluidas en un estudio transversal de evaluación de la eficacia de la BSGC usando la técnica mixta de inyección cervical de 99mTc-nanocoloide de albúmina y azul de metileno, empleando linfogammagrafía planar combinada con imagen multimodalidad SPECT/TC y posterior extirpación del GC mediante laparoscopia.

Resultados

La tasa de detección de la BSGC con técnica mixta fue del 95,6%, siendo el valor predictivo negativo (VPN) del 95,4% y la sensibilidad (S) del 100% en caso de drenaje bilateral. La media de GC extirpados fue de 3 (rango 1-5). La tasa de detección bilateral en la laparoscopia fue del 85,3%. La concordancia entre SPECT/TC y laparoscopia para el número y bilateralidad del GC mediante el coeficiente de Pearson fue r=0,73 y r=0,83, respectivamente; p=0,01. Solo encontramos un GC con resultado diferido de micrometástasis y se detectó un falso negativo.

Conclusiones

La BSGC en CC mediante técnica mixta tiene una elevada tasa de detección y de drenaje bilateral, pero aún la S es baja si incluimos casos de drenaje unilateral. Un mayor número de casos y el desarrollo de la ultraestadificación intraoperatoria podrían aumentar la S de la técnica y reducir el número de falsos negativos.

Palabras clave:
Biopsia del ganglio linfático centinela
Azul de metileno
99mTc-nanocoloide
Laparoscopia
Neoplasias de cuello uterino

Article

These are the options to access the full texts of the publication Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos