一项单中心前瞻性非随机研究，旨在评估系统开发的基于解剖学的前哨淋巴结 (SLN) 算法在宫颈癌中的应用。2014 年 9 月至 2023 年 1 月期间，连续接受机器人根治性子宫切除术/子宫颈切除术的女性，FIGO 2009 1A2-2A1 期宫颈癌患者宫颈注射吲哚菁绿（ICG）作为示踪剂用于检测骨盆前哨淋巴结。遵循基于解剖学的手术算法；将 SLN 定义为上、下宫颈旁淋巴通路内的近子宫映射节点，包括单独去除子宫旁淋巴管组织 (PULT)。进行了完整的盆腔淋巴结切除术。对 SLN（包括 PULT）进行了超分期和免疫组织化学分析。181 名女性被纳入分析。中位组织学肿瘤大小为 14.0 毫米（范围 2-80 毫米）。双侧测绘率为98.3%。根据方案，中期分析拒绝了 H0，并在 29 名淋巴结阳性女性中停止纳入，所有女性均由至少一个 ICG 定义的转移性 SLN 识别。一名在研究结束时等待组织学检查的女性呈淋巴结阳性，并纳入分析。灵敏度为 100%（95% CI，88.4%-100%），NPV 100%（95% CI，97.6%-100%）。在淋巴结阳性女性中，近端闭孔位置占所有 SLN 转移灶的 46.1%，这是 PULT 中 40% 和 10% 中唯一有孤立转移灶的位置。严格遵守基于解剖学的 SLN 算法，包括识别主要通路内的平行淋巴管，尤其是闭孔室、PULT 评估、限制淋巴结清扫以切除 SLN，可准确识别早期宫颈癌的盆腔淋巴结转移性疾病。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

A single center prospective non-randomized study to assess a systematically developed anatomically-based sentinel lymph node (SLN) algorithm in cervical cancer.Consecutive women with FIGO 2009 stage 1A2-2A1 cervical cancer undergoing robotic radical hysterectomy/trachelectomy between September 2014 and January 2023 had cervically injected Indocyanine Green (ICG) as a tracer for detection of pelvic SLN. An anatomically based surgical algorithm was adhered to; defining SLNs as the juxtauterine mapped nodes within the upper and lower paracervical lymphatic pathways including separate removal of the parauterine lymphovascular tissue (PULT). A completion pelvic lymphadenectomy was performed. Ultrastaging and immunohistochemistry was performed on SLNs, including the PULT.181 women were included for analysis. Median histologic tumor size was 14.0 mm (range 2-80 mm). The bilateral mapping rate was 98.3%. As per protocol an interim analysis rejected H0 and inclusion stopped at 29 node positive women, all identified by at least one metastatic ICG-defined SLN. One woman awaiting histology at study-closure was node positive and included in the analysis. Sensitivity was 100% (95% CI, 88.4%-100%) and NPV 100% (95% CI, 97.6%-100%). In node positive women, the proximal obturator position harbored 46.1% of all SLN metastases representing the only position in 40% and 10% had isolated metastases in the PULT.Strictly adhering to an anatomically based SLN-algorithm including identification of parallell lymphatics within major pathways, partilularly the obturator compartment, assessment of the PULT, restricting nodal dissection to the removal of SLNs accurately identifies pelvic nodal metastatic disease in early-stage cervical cancer.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.