oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2018-17-1-82-91oncotomsk-675Research ArticleОБЗОРЫREVIEWSВЫЯВЛЕНИЕ СТОРОЖЕВЫХ ЛИМФАТИЧЕСКИХ УЗЛОВ ПРИ ОРГАНОСОХРАНЯЮЩЕМ ЛЕЧЕНИИ ИНВАЗИВНОГО РАКА ШЕЙКИ МАТКИDETECTION OF SENTINEL LYMPH NODES IN ORGAN-PRESERVING TREATMENT FOR INVASIVE CERVICAL CANCERhttps://orcid.org/0000-0002-8194-2811ЧернышоваА. Л.ChernyshovaA. L.

Чернышова Алена Леонидовна - доктор медицинских наук, ведущий научный сотрудник отделения гинекологии с группой профилактики, Author ID: 55220758100. Reseacher ID: C-8608-2012, SPIN-код: 2522-7513.

634009, Томск, пер. Кооперативный, 5

Alyena L. Chernyshova - MD, DSc, Leading Researcher, Department of Gynecology with the Group of Cancer Prevention, Author ID Scopus: 55220758100, Reseacher ID: C-8608-2012, SPIN-code: 2522-7513.

https://orcid.org/0000-0002-6854-8940КоломиецЛ. А.KolomietsL. A.

Коломиец Лариса Александровна - доктор медицинских наук, профессор, заведующая отделением гинекологии с группой профилактики, НИИО ТНИМЦ РАН; профессор кафедры онкологии СГМУ, Author ID: 7004921120. Reseacher ID: C-8573-2012.

634009, Томск, пер. Кооперативный, 5; 634050, Томск, Московский тракт, 2

Larisa A. Kolomiets - MD, DSc, Professor, Head of Department of Gynecology with the Group of Cancer Prevention CRITNRMC RAS; Profossor of Oncology Department SState MU, Author ID: 7004921120, Reseacher ID: C-8573-2012.

5, Kooperativny Str., 634009-Tomsk; 2, Moskovsky Tract, 634050-Tomsk

kolomietsla@oncology.tomsk.ruhttps://orcid.org/0000-0002-5524-9546ЧерновВ. И.ChernovB. I.

Чернов Владимир Иванович - доктор медицинских наук, профессор, заместитель директора по научной работе и инновационной деятельности, заведующий отделением радионуклидной диагностики, Researcher ID: B-6789-2016. Author ID: 7201429550. SPIN-код: 6301-3612.

Vladimir I. Chernov - MD, DSc, Professor, Deputy Director for Science and Innovation, Head of Nuclear Medicine Department, Researcher ID: B-6789-2016, Author ID: 7201429550, SPIN-code: 6301-3612.

5, Kooperativny Str., 634009-Tomsk

https://orcid.org/0000-0001-6351-6408СинилкинИ. Г.SinilkinI. G.

Синилкин Иван Геннадьевич - кандидат медицинских наук, старший научный сотрудник отделения радионуклидной диагностики, Scopus ID: 6506263379. Researcher ID: C-9282-2012. SPIN-код: 7254-3474.

634009, Томск, пер. Кооперативный, 5

Ivan G. Sinilkin - MD, PhD, Senior Researcher, Nuclear Medicine Department, Scopus ID: 6506263379. Researcher ID: C-9282-2012, SPIN-code: 7254-3474.

Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наукРоссияCancer Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesRussian FederationНаучно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук; ГОУ ВПО «Сибирский государственный медицинский университет» Минздрава РФРоссияCancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical UniversityRussian Federation2018040320181718291Copyright © Чернышова А.Л., Коломиец Л.А., Чернов В.И., Синилкин И.Г., 20182018Чернышова А.Л., Коломиец Л.А., Чернов В.И., Синилкин И.Г.Chernyshova A.L., Kolomiets L.A., Chernov B.I., Sinilkin I.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/675

При начальных стадиях рака шейки матки радикальность расширенных операций значительно превосходит необходимую, в связи с чем проводятся исследования, направленные на оценку эффективности органосохраняющих подходов к хирургическому лечению рака шейки матки. С этой проблемой тесно связана проблема оценки диагностической эффективности детекции «сторожевых» лимфатических узлов (СЛУ) и особенностей лимфатического оттока от шейки матки. Концепция СЛУ особенно актуальна для определения показаний к проведению органосохраняющего либо адъювантного лечения. В обзоре освещены проблемы клинического значения биопсии СЛУ и определения микрометастазов, которые невозможно выявить при помощи традиционных методик. Представлена диагностическая эффективность различных методов введения препаратов для последующей визуализации. В сравнительном аспекте рассматриваются результаты применения радиофармпрепаратов и витальных красителей для детекции СЛУ, а также их сочетанное применение. Представлены отечественные инновационные методики определения сторожевых лимфоузлов.

For early stages of cervical cancer, minimally invasive surgery leads to more beneficial outcomes compared to results of more extensive surgery. In this connection, the studies that focus on the assessment of the efficacy of organ-preserving and functionally-sparing approaches to surgical treatment of cervical cancer are of great significance. Sentinel lymph node (SLN) biopsy is the preferred method for assessing pelvic nodal basin status in patients with early stage cervical cancer. The concept of sentinel lymph nodes is especially relevant in cases where the status of lymph nodes is the most important factor in the expediency of performing organ-preserving or adjuvant treatment. The review highlights the problems of the clinical significance of SLN biopsy in detection of metastases that could not be detected using traditional techniques. The diagnostic  effectiveness of various routes of tracer injection for SLN visualization was assessed. The comparative results of the use of radiopharmaceuticals used either alone or in combination with blue dye for identification of SLNs were shown. The innovative technique for SLN detection were presented.

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The authors declare that there are no conflicts of interest present.