| 田小娟,索玉平,王 茜.腹主动脉旁淋巴结切除术在宫颈癌中的价值及争议[J].肿瘤学杂志,2021,27(5):405-408. |
| 腹主动脉旁淋巴结切除术在宫颈癌中的价值及争议 |
| Value and Controversy of Para-aortic Lymph Node Dissection in Cervical Cancer |
| 投稿时间：2020-10-16 |
| DOI：10.11735/j.issn.1671-170X.2021.05.B015 |
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| 中文关键词: 宫颈癌 腹主动脉旁淋巴结 手术范围 |
| 英文关键词:cervical cancer paraaortic lymph nodes scope of operation |
| 基金项目:国家自然科学基金项目（61775128，6197032300） |
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| 摘要点击次数: 971 |
| 全文下载次数: 261 |
| 中文摘要: |
| 摘 要：宫颈癌中淋巴结的转移与疾病分期、预后、治疗方式的选择密切相关，腹主动脉旁淋巴结（para-aortic lymph node，PLAN）转移是预后不良的一个独立因素。国际妇产科联盟（FIGO）2018年对宫颈癌分期做出了修改，将影像学或组织病理学证实的主动脉旁淋巴结转移患者定为ⅢC2期。2020年美国国立综合癌症网络(NCCN) 宫颈癌治疗指南指出，对ⅠB1~ⅡA2宫颈癌患者可选择腹主动脉旁淋巴结取样术，对ⅡB~ⅣA期患者可选择分期手术即先行腹膜外或腹腔镜下淋巴结切除术。但是目前宫颈癌患者的腹主动脉旁淋巴结清扫术（para-aortic lymphadenectomy，PAL）仍缺乏足够的证据，另外腹主动脉旁淋巴结清扫水平如何定位、PAL能否延长患者生存期等问题仍存在较多争议。全文针对这些问题作一简要综述。 |
| 英文摘要: |
| Abstract：Lymph node metastasis in cervical cancer is closely related to the disease staging，prognosis and treatment methods，and para-aortic lymph node(PLAN) metastasis is an independent risk factor for adverse prognosis. The International Federation of Obstetrics and Gynecology(FIGO) revised the cervical cancer staging in 2018，and the cervical cancer with para-aortic lymph node metastasis confirmed by imaging or histopathology is designated as stage ⅢC2. The National Comprehensive Cancer Network(NCCN) 2020 Guidelines for the Treatment of Cervical Cancer state that para-aortic lymph node sampling is an option for patients with ⅠB1~ⅡA2 cervical cancer，and staging surgery with extraperitoneal or laparoscopic lymph node dissection is an option for patients with ⅡB~ⅣA cancer. However，at present，the rationale of para-aortic lymphadenectomy(PAL) for patients with cervical cancer is still lacking enough evidence，and there is controversy about how to locate the level of dissection and whether PAL can extend the survival time of patients. In view of these problems，this article makes a brief summary. |
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