PDF(Pubmed)
Abstract：
UNASSIGNED: Currently, sentinel lymph node biopsy (SLNB) is increasingly used in endometrial cancer, but the rate of missed metastatic lymph nodes compared to systemic lymph node dissection has been a concern. We conducted a systematic review and meta-analysis to evaluate the false negative rate (FNR) of SLNB in patients with endometrial cancer and to explore the risk factors associated with this FNR.
UNASSIGNED: Three databases (PubMed, Embase, Web of Science) were searched from initial database build to January 2023 by two independent reviewers.
UNASSIGNED: Studies were included if they included 10 or more women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I or higher endometrial cancer, the study technique used sentinel lymph node localization biopsy, and the reported outcome metrics included false negative and/or FNR.
UNASSIGNED: Two authors independently reviewed the abstracts and full articles. The FNR and factors associated with FNR were synthesized through random-effects meta-analyses and meta-regression.
UNASSIGNED: We identified 62 eligible studies. The overall FNR for the 62 articles was 4% (95% CL 3-5).There was no significant difference in the FNR in patients with high-risk endometrial cancer compared to patients with low-risk endometrial cancer. There was no difference in the FNR for whether frozen sections were used intraoperatively. The type of dye used intraoperatively (indocyanine green/blue dye) were not significantly associated with the false negative rate. Cervical injection reduced the FNR compared with alternative injection techniques. Indocyanine green reduced the FNR compared with alternative Tc-99m. Postoperative pathologic ultrastaging reduced the FNR.
UNASSIGNED: Alternative injection techniques (other than the cervix), Tc-99m dye tracer, and the absence of postoperative pathologic ultrastaging are risk factors for a high FNR in endometrial cancer patients who undergo SLNB; therefore, we should be vigilant for missed diagnosis of metastatic lymph nodes after SLNB in such populations.
UNASSIGNED: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023433637.
UNASSIGNED: Three databases (PubMed, Embase, Web of Science) were searched from initial database build to January 2023 by two independent reviewers.
UNASSIGNED: Studies were included if they included 10 or more women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I or higher endometrial cancer, the study technique used sentinel lymph node localization biopsy, and the reported outcome metrics included false negative and/or FNR.
UNASSIGNED: Two authors independently reviewed the abstracts and full articles. The FNR and factors associated with FNR were synthesized through random-effects meta-analyses and meta-regression.
UNASSIGNED: We identified 62 eligible studies. The overall FNR for the 62 articles was 4% (95% CL 3-5).There was no significant difference in the FNR in patients with high-risk endometrial cancer compared to patients with low-risk endometrial cancer. There was no difference in the FNR for whether frozen sections were used intraoperatively. The type of dye used intraoperatively (indocyanine green/blue dye) were not significantly associated with the false negative rate. Cervical injection reduced the FNR compared with alternative injection techniques. Indocyanine green reduced the FNR compared with alternative Tc-99m. Postoperative pathologic ultrastaging reduced the FNR.
UNASSIGNED: Alternative injection techniques (other than the cervix), Tc-99m dye tracer, and the absence of postoperative pathologic ultrastaging are risk factors for a high FNR in endometrial cancer patients who undergo SLNB; therefore, we should be vigilant for missed diagnosis of metastatic lymph nodes after SLNB in such populations.
UNASSIGNED: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023433637.
摘要：
■目前，前哨淋巴结活检（SLNB）越来越多地用于子宫内膜癌，但与系统性淋巴结清扫术相比，转移性淋巴结的遗漏率一直是一个令人担忧的问题。我们进行了系统评价和荟萃分析，以评估子宫内膜癌患者SLNB的假阴性率（FNR），并探讨与该FNR相关的危险因素。
■三个数据库（PubMed，Embase,WebofScience）由两名独立的审阅者从初始数据库构建到2023年1月进行了搜索。
■如果研究包括10名或更多被诊断患有国际妇产科联合会（FIGO）I期或更高级别子宫内膜癌的妇女，研究技术采用前哨淋巴结定位活检，报告的结果指标包括假阴性和/或FNR。
■两位作者独立审阅了摘要和全文。通过随机效应meta分析和meta回归综合FNR和与FNR相关的因素。
■我们确定了62项符合条件的研究。62篇文章的总体FNR为4%(95%CL3-5)。与低风险子宫内膜癌患者相比，高危子宫内膜癌患者的FNR没有显着差异。术中是否使用冷冻切片的FNR没有差异。术中使用的染料类型（吲哚菁绿/蓝染料）与假阴性率没有显着相关。与替代注射技术相比，宫颈注射降低了FNR。与其他Tc-99m相比，吲哚菁绿降低了FNR。术后病理超常降低FNR。
■替代注射技术（子宫颈除外），Tc-99m染料示踪剂,和术后病理超常的缺乏是子宫内膜癌SLNB患者高FNR的危险因素；因此，我们应警惕此类人群SLNB后转移性淋巴结的漏诊.
■http://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42023433637。
■三个数据库（PubMed，Embase,WebofScience）由两名独立的审阅者从初始数据库构建到2023年1月进行了搜索。
■如果研究包括10名或更多被诊断患有国际妇产科联合会（FIGO）I期或更高级别子宫内膜癌的妇女，研究技术采用前哨淋巴结定位活检，报告的结果指标包括假阴性和/或FNR。
■两位作者独立审阅了摘要和全文。通过随机效应meta分析和meta回归综合FNR和与FNR相关的因素。
■我们确定了62项符合条件的研究。62篇文章的总体FNR为4%(95%CL3-5)。与低风险子宫内膜癌患者相比，高危子宫内膜癌患者的FNR没有显着差异。术中是否使用冷冻切片的FNR没有差异。术中使用的染料类型（吲哚菁绿/蓝染料）与假阴性率没有显着相关。与替代注射技术相比，宫颈注射降低了FNR。与其他Tc-99m相比，吲哚菁绿降低了FNR。术后病理超常降低FNR。
■替代注射技术（子宫颈除外），Tc-99m染料示踪剂,和术后病理超常的缺乏是子宫内膜癌SLNB患者高FNR的危险因素；因此，我们应警惕此类人群SLNB后转移性淋巴结的漏诊.
■http://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42023433637。
