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Abstract：
BACKGROUND: Since October 2018, lymph node status has become part of the FIGO staging, given that it is one of the most important prognostic factors among women with CC. The aim was to determine the rate of atypical lymphatic drainage in patients with clinical early-stage cervical cancer using a hybrid tracer (ICG-99mTc nanocolloid).
METHODS: A prospective, observational, single-centre study conducted at Son Espases University Hospital between January 2019 and October 2023. Patients with clinical early-stage CC who underwent SLN mapping were included. External iliac and obturator nodes were defined as common locations. Para-aortic, common iliac, presacral, internal iliac, and parametrial nodes were defined as atypical locations.
RESULTS: Thirty-nine cases of CC were included. The overall SLN detection rate was 97.4%, with 89.5% bilaterally. Positive nodes were found in 21.1% of patients. Atypical lymphatic drainage was present in 8 out of 38 (21.1%) patients. Of all the SLNs biopsied (146), 10.3% corresponded to an atypical zone. SLN in the atypical area had a higher proportion of metastasis than the usual area (37.5% vs. 16.7%; p = 0.327).
CONCLUSIONS: SLN biopsy can detect unusual drainage in a significant proportion of patients. Atypical lymph nodes have a higher percentage of metastasis, which consequently improves staging and tailoring therapy. SLN mapping performed via a standardized surgical technique using a hybrid tracer (ICG-99mTc) could help in the identification of the \"true SLN\".
METHODS: A prospective, observational, single-centre study conducted at Son Espases University Hospital between January 2019 and October 2023. Patients with clinical early-stage CC who underwent SLN mapping were included. External iliac and obturator nodes were defined as common locations. Para-aortic, common iliac, presacral, internal iliac, and parametrial nodes were defined as atypical locations.
RESULTS: Thirty-nine cases of CC were included. The overall SLN detection rate was 97.4%, with 89.5% bilaterally. Positive nodes were found in 21.1% of patients. Atypical lymphatic drainage was present in 8 out of 38 (21.1%) patients. Of all the SLNs biopsied (146), 10.3% corresponded to an atypical zone. SLN in the atypical area had a higher proportion of metastasis than the usual area (37.5% vs. 16.7%; p = 0.327).
CONCLUSIONS: SLN biopsy can detect unusual drainage in a significant proportion of patients. Atypical lymph nodes have a higher percentage of metastasis, which consequently improves staging and tailoring therapy. SLN mapping performed via a standardized surgical technique using a hybrid tracer (ICG-99mTc) could help in the identification of the \"true SLN\".
摘要：
背景：自2018年10月以来，淋巴结状态已成为FIGO分期的一部分，鉴于它是CC女性中最重要的预后因素之一。目的是使用混合示踪剂（ICG-99mTc纳米胶体）确定临床早期宫颈癌患者的非典型淋巴引流率。
方法：前瞻性，观察,2019年1月至2023年10月在SonEspases大学医院进行的单中心研究。包括接受SLN映射的临床早期CC患者。外髂和闭孔淋巴结被定义为常见位置。主动脉旁,髂总,骶前,髂内,和副子宫节点被定义为非典型位置。
结果：共39例CC。总体SLN检出率为97.4%,双边占89.5%。21.1％的患者发现阳性淋巴结。38例患者中有8例（21.1％）存在非典型淋巴引流。在所有活检的SLN中（146），10.3％对应于非典型区域。非典型区域的SLN转移比例高于通常区域（37.5％vs.16.7%；p=0.327）。
结论：SLN活检可在相当比例的患者中发现异常引流。不典型淋巴结转移比例较高,从而改善分期和剪裁疗法。通过使用混合示踪剂（ICG-99mTc）的标准化手术技术进行的SLN标测可以帮助识别“真正的SLN”。
方法：前瞻性，观察,2019年1月至2023年10月在SonEspases大学医院进行的单中心研究。包括接受SLN映射的临床早期CC患者。外髂和闭孔淋巴结被定义为常见位置。主动脉旁,髂总,骶前,髂内,和副子宫节点被定义为非典型位置。
结果：共39例CC。总体SLN检出率为97.4%,双边占89.5%。21.1％的患者发现阳性淋巴结。38例患者中有8例（21.1％）存在非典型淋巴引流。在所有活检的SLN中（146），10.3％对应于非典型区域。非典型区域的SLN转移比例高于通常区域（37.5％vs.16.7%；p=0.327）。
结论：SLN活检可在相当比例的患者中发现异常引流。不典型淋巴结转移比例较高,从而改善分期和剪裁疗法。通过使用混合示踪剂（ICG-99mTc）的标准化手术技术进行的SLN标测可以帮助识别“真正的SLN”。
