Detection efficacy and influencing factors of different tracers for sentinel lymph nodes in patients with early-stage cervical cancer and endometrial cancer under laparoscopy
JIANG Qin
LU Yan
HE Hongying
CHEN Guowei
WU Xuefeng
YE Yuan
CAI Jian
LEI Zhiying
LEI Jia
LI Meiying
LI Jianxiang
ZENG Dingyuan
WEI Yeping
ZHAO Renfeng
LI Yongming
FAN Jiangtao
YAO Desheng
Abstract：Objective To compare the detection efficacy of different tracers[carbon nanoparticles(CNP),methy-lene blue,indocyanine green(ICG),and ICG+CNP]for sentinel lymph nodes(SLN)in patients with early-stage cervical cancer and endometrial cancer undergoing laparoscopic surgery,and to analyze factors influencing the SLN detection.Methods Clinical data of 848 early-stage cervical cancer patients and 769 endometrial cancer patients from 13 Grade-A tertiary hospitals in Guangxi Province were retrospectively analyzed.All patients underwent laparoscopic SLN mapping with cervical injection of one tracer(CNP,methylene blue,ICG,or ICG+CNP),followed by SLN biopsy and systematic pelvic/para-aortic lymphadenectomy.SLN and non-sentinel lymph nodes(nSLN)were histopathologically examined.The overall SLN detection rates of four tracers were compared,and their diagnostic performance[specificity,negative predictive value(NPV),and accuracy]for SLN positivity was evaluated.Multivariate Logistic regression was used to analyze the indepen-dent factors affecting SLN detection.Results In cervical cancer patients,SLN detection rates were 83.8%(ICG),65.1%(methylene blue),67.1%(CNP),and 88.9%(ICG+CNP),with an overall rate of 69.9%.For endometrial can-cer,the rates were 93.6%(ICG),57.9%(methylene blue),84.8%(CNP),and 100%(ICG+CNP),with an overall rate of 77.4%.ICG+CNP showed the highest detection rate SLN in both cancers,while methylene blue had the lowest(all P<0.05).No significant differences were observed in specificity,NPV,or accuracy among tracers(all P>0.05).Mul-tivariate Logistic regression analysis revealed that the advanced age(OR=0.974,95%CI:0.958-0.989)was a protective factor for SLN detection in cervical cancer;IB1 stage(OR=3.085,95%CI:1.108-8.586)and IB2 stage(OR=4.126,95%CI:1.452-11.725)were independent risk factors for cervical cancer;LVSI(OR=0.721,95%CI:0.443-1.175)was a protective factor for endometrial cancer(all P<0.05).Conclusions ICG+CNP achieves the highest SLN detection rate in both early-stage cervical and endometrial cancers,with ICG and CNP showing moderate efficacy and methylene blue the lowest.All tracers exhibit comparable diagnostic performance for SLN positivity.Age and clinical stage influence SLN detection in early-stage cervical cancer,while lymphovascular space invasion affects SLN detection in endometrial cancer.
Keywords：sentinel lymph nodecervical carcinomaendometrial carcinomacarbon nanoparticlesmethylene blueindocyanine greentracing technique
Publication Date：2025-06-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 52-57 )