Detection For Micrometastasis In Sentinel Lymph Node Early Stage Cervical Cancer

Objective:Lymph node micrometastasis was difficult to be detected by conventional pathology.Pathologic ultrastaging might have diagnostic value for micrometastasis and also improve the sensitivity of Sentinel lymph node biopsy(SLNB).This study aims to investigate the detection of cervical cancer Sentinel lymph node(SLN)micrometastasis as well as to evaluate the sensitivity of SLN pathologic ultrastaging of SLNB.Methods:We analyzed 100 patients'data with FIGO 2009 stages IA2-IIA2 cervical cancer in the Affiliated Tumor Hospital of Guang Xi Medical University.All of these patients underwent SLN mapping with nanocarbon,at least one SLN was successfully detected;All SLN that were negative for metastasis on the initial routine section stained by H&E were further examined according to the pathologic ultrastaging protocol.Results:Bilateral SLN detection was 71%and unilateral SLN detection was 29%in 100 patients;The SLN positive rate was 27%,in which the macrometastasis and micrometastasis accounted for 14%and 13%respectively;Bilateral SLN positive rate(35.21%)was higher than that of unilateral(6.9%),?2=8.375,P=0.004;2 cases of false negative appeared in patients with unilateral SLN detection and no SLN detection was observed on the same side,while no false negative cases were observed on bilateral SLN detection.Sensitivity of SLN ultrastaging:93.10%,95%CI:83.29%-102.91%,The specificity was 97.26,95%CI:93.52%?101.01%,and the accuracy was 98%,95%CI:95.21%-100.79%.Conclusion:SLN pathologic ultrastaging can improve the detection rate of metastasis.Bilateral SLN detection and pathologic ultrastaging can reduce false negative rate,in which case SLNB should be feasible.