The Further Study Of Interstitial Magnetic Resonance Lymphography In The Dlagnosis Of Lymph Nodal Metastases In Cevical Cancer

Objective: 1. Study on the feasibility of performing interstitial magnetic resonance (MR) lymphography on the patients with cervical cancer to evaluate pelvis nodal metastasis.2. Investigate the relationship between the clinical stage of cervical cancer and lymph node metastasis, and standardized treatment for cervical cancer. Analyze the realationship between lymph node metastasis of cervical cancer and its TCM syndrome, to study on cervical cancer treated by integrated traditional Chinese and western medicine.Methods: 1.In the 23patients with cervical cancer,which were performed pelvic lymphography from January 2006 to March 2009 in Nanjing Drum-tower Hospital, by magnetic resonance interstitial lmphography observe the situation of pelvis lympgatic vessel drainage and the nodal metastasis.21 cases were successfully operated on, comparison for MR interstitial lymphography and pathological examination.2. To collect data from 73 patients with cervical cancer and through surgical treatment (contained pelvic lymph node biopsy or pelvic lymph node dissection), between January 2005 and follow up to the end of December 2008. According to TCM syndrome and the Related Factors of metastasis retrospectively classify .Results: 1.A11 of 23 patients with cervical cancer performed successfully to MR interstitial lymphography, the lymph node morphology and drainage lymphatic vessels were visualized clearly.2.In the 23 patients, 21patients have pathologic correlation. MR interstitial lymphography predict lymphatic metastasis of cervical cancer. Its accuracy is 95.23%(20/21);the sensitivity is 80%(4/5);the specificity is 100%(16/16).3.12patients with pelvic lymphatic metastasis in 73 of cervical cancer, account for16.44%, which all of 26cases stage la are no lymphatic metastasis; the metastasis rate of stage was 3.57%(1/28); the metastasis rate of stage Ib2 was 28.57%(2/7); All of the 2cases in stage IIa have no metasstasis; 3 in stage IIb, which one antecedence used chemotherapy and no metastasis,the other two appeared metastasis; All of the 7 in stage III occurred lymhatic metastasis. In those 12cases with metastasis,the obturatou ranked firstand ,and the followed order of internal iliac> ingguinal>commom iliac>external iliac.4.73patients with cervical cancer were mainly damp heat and phlegm retention syndrome. After syndrome differentiation: which the metastasis of concurrently liver depression syndrome was 14.29%(2/14); which the metastasis of concurrently spleen deficiency syndrome was 11.53%(3/26); which the metastasis of concurrently Yin Deficiency Syndrome was 27.27%(3/21); which the metastasis of concurrently Yang Deficiency syndrome were was 33.33%(4/12).Concusion: 1. It is feasible to perform MR interstitial lymphography on patients with cervical cancer.2. It is the best way that is by cervical interstitial in the current research.3. The pelvic lymphatic metastasis of cervical cancer was closely related with clinical stage and interstitial infiltration, was possible correlation with pathological types and classification.4. TCM syndrome differentiation and Typing mainly reflect petient body of comprehensive state, the results showed that: the patients without lymphatic metastasis of cervical cancer were mainly damp heat and phlegm retention syndrome concurrently spleen deficiency syndrome; the patients with metastasis were mainly damp heat and phlegm retention syndrome concurrently Yang deficiency syndrome.5.MR interstitial lymphography could display the states of sentinel lymph node,and would provid clinical datas for the sentinel node biopsy with cervical cancer.