Resumo

SUAREZ, Carmen María et al. Mapeo linfático intraoperatorio e identificación: Del ganglio centinela en pacientes con estadios tempranos de carcinoma de cuello uterino. Rev. venez. oncol. [online]. 2005, vol.17, n.1, pp.2-15. ISSN 0798-0582.

OBJECTIVES: Study the feasibility and diagnostic accuracy of sentinel lymph node detection in patients with early cervical cancer. METHODS: Between December 2001 and April 2004, 28 patients with preoperative diagnosis of early cervical carcinoma underwent radical abdominal hysterectomy with bilateral pelvic dissection. Twenty two patients were eligible for this study. On the day prior to surgery 4.5 mCi of filtered technicium-99 radiocolloid was injected into the cervix around the tumor in four quadrants. Static lymphoscintigraphy was performed. On the day of surgery blue dye was injected in the cervix after induction of general anesthesia. Intraoperatively the sentinel lymph node was searched under direct vision and with the aid of a gammaprobe. Radical abdominal hysterectomy and bilateral pelvic lymphadenectomy were performed in the usual manner. The sentinel lymph nodes were sent to frozen section and the surgical specimen was sent separately for histopathogical analysis. Negative sentinel lymph nodes on routine hematoxilin-eosin staining were submitted to immunohistochemical studies. RESULTS: The sentinel lymph node or nodes were identified in 19 patients, with an identification rate of 86.4 %. A total of 40 sentinel nodes were evaluated; routine hematoxilin-eosin staining and immunohistochemical studies were negative for metastases. 63.33 % of these sentinel nodes had an external iliac location. No metastases were found in non-sentinel lymph nodes. CONCLUSION: Sentinel lymph node identification in cervical carcinoma is feasible. The combined method must be used in order to achieve the best results with the procedure.

Palavras-chave : Cancer; uterine cervix; diagnoses; sentinel lymph node; lynphadenectomy.