The Value Of Indocyanine Green Combined With Isosulfan Blue In Sentinel Lymph Node Tracing In Uterine Malignant Tumors

Objective:To investigate the value of Indocyanine green(ICG)combined with isosulfan blue(ISB)for detecting Sentinel lymph node(SLN)in the operation of uterine malignant tumors.Methods:A total of 30 patients with uterine malignant tumors who underwent open surgery in our hospital were selected,including 20 cases of endometrial carcinoma and 10 cases of cervical cancer.ISB(1ml)were injected into the cervix of cervical cancer at 6 and 12 points and ICG(1ml)was injected into the cervix at 3 and 9 points.ISB(1ml)and ICG(1ml)were injected around the lesion in the patients with endometrial carcinoma.The amount and location of SLN was identified and recorded during the operation.All lymph nodes were examined by hematoxylin-eosin staining,then evaluate the detection rate,sensitivity,negative predictive value and accuracy of SLN.Results:1 The total detection rate of ICG combined with ISB was 40%(12/30),and the detection rates of ICG and ISB were 36.7%(11/30)and 10%(3/30),respectively.The detection rate of ICG was higher than that of ISB(P<0.05).The detection rate of ICG combined with ISB was higher than ISB tracing method(P<0.05).The detection rate of ICG combined with ISB has no statistical significance with ICG(P>0.05).2 The sensitivity of ICG combined with ISB in tracing SLN is 100%(1/1),and the sensitivity of ICG and ISB are 100%(1/1)and 0(0/1),respectively.The negative predictive value of ICG combined with ISB in tracing SLN was 100%(11/11),and the negative predictive value of ICG and ISB were 100%(10/10)and 100%(3/3),respectively.The accuracy of ICG combined with ISB in tracing SLN is 100%(12/12),and the accuracy of ICG and ISB are 100%(11/11)and 100%(3/3),respectively.3 SLN of endometrial cancer is mainly located in obturator(37.8%)and extravascular(37.8%).The SLN of cervical cancer is mainly located in obturator(37.5%)and extravascular(25.0%).Conclusion:1 ICG combined with ISB have high sensitivity,negative predictive value and accuracy in SLN tracing,and can be used as a method to predict lymph node metastasis in early uterine malignant tumors.But the detection rate is not high.The detection rate of ICG is higher than ISB,and ICG combined with ISB is higher than that of ISB.So it is necessary to further improve the method and the technical proficiency to increase the detection rate.2 The SLN of endometrial cancer and cervical cancer are mainly located in the obturator and the extravascular.