| Co-Investigator(Kenkyū-buntansha) |
YAEGASHI Nobuo Tohoku University, Graduate school of medicine, Professor, 大学院・医学系研究科, 教授 (00241597)
ITO kiyoshi Tohoku University, Graduate school of medicine, Assistant Professor, 大学院・医学系研究科, 助教授 (70241594)
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| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2005: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 2004: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Research Abstract |
46 patients with endometrial cancer who were scheduled for total abdominal hysterectomy, bilateral salpingo-oophorectomy, total pelvic lymphadenectomy and paraaortic lymphadenectomy at Tohoku University School of Medicine underwent sentinel lymph node detection. On the day before surgery, preoperative lymphoscintigraphy was performed by injection of 99m-Technetium (Tc)-labelled phytate into the endometrium during hysteroscopy. At the time of surgery, a gamma-detecting probe was used to locate radioactive lymph nodes. At least one sentinel node was detected in 38 of the 46 patients (83%). The mean number of sentinel nodes was 3.1 (range, 1-9). Sentinel nodes could be identified in 31 of 35 patients (89%) whose tumor did not invade more than halfway into the myometrium. Twelve patients had radioactive nodes in the paraaortic area. Only 7 patients did not have sentinel node in the following three sites : paraaortic, external iliac and obturator. The sensitivity and specificity for detecti
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ng lymph node matastases were both 100%.
A total of 39 consecutive patients with cervical cancer scheduled for radical hysterectomy and total pelvic lymphadenectomy at our hospital underwent SLN detection study. The day before surgery, lymphoscintigraphy was performed with injection of 99m-Technetium (^<99m>Tc)-labeled phytate into the uterine cervix. At surgery, patients underwent lymphatic mapping with a gamma-detecting probe and patent blue injected into the same points as the phytate solution. At least one positive node was detected in 34 patients (87%). Most sentinel nodes were in one of the following sites : external iliac, obturator, and parametrial. The sensitivity, specificity, and negative predictive value for SLN detection were all 100%.
20 patients underwent laparotomy (total abdominal hysterectomy, bilateral salpingo-oophorectomy, total pelvic lymphadenectomy and para-aortic lymphadenectomy to the level of renal veins) with SLN biopsy for endometrial cancer at Tohoku University Hospital were enrolled in this study. Excluded were patients in whom lymph node metastasis was detected by routine histological examination or no SLN could be detected. All surgically removed lymph nodes, including SLNs, were examined histopathologically by immunohistochemistry staining with an anti-cytokeratin antibody (AE1/AE3) utilizing step-serial section at 200-500m interval. Three of 20 patients (15%) had micrometastasis and 1 patient had isolated tumor cell in SLNs. On the other hand, in 4 of 668 non-SLNs obtained from 10 patients (0.6%), micrometastasis could be detected. The micrometastases were detected in the external iliac basin (2 cases) and in the paraaortic area (2 cases). Isolated tumor cell was detected in the external iliac basin(1 case). Less
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