Abstract:

Objective To compare the clinicopathological features of patients with false negative and true negative pathological biopsy of sentinel lymph nodes in endometrial cancer， and to explore the related factors of missed diagnosis of sentinel lymph nodes. Methods From January 2020 to January 2022， 31 patients underwent sentinel lymph node biopsy combined with systematic lymph node resection in the First Affiliated Hospital of Shandong First Medical University were retrospectively analyzed， of which 2 were false negative and 29 were true negative. PubMed literature on sentinel lymph node false negative of endometrial cancer was searched from the establishment of the database to December 2022， with the search terms “Sentinel lymph node” “Endometrial neoplasms” and “False negative”. A total of 15 cases of false negative patients with similar methods to this study were extracted. In the false negative group， there were 17 false negative patients with sentinel lymph node negative but systemically excised lymph node positive， including 2 cases in our hospital and 15 cases in the literature. The true negative group included 29 true negative patients with negative sentinel and systemic lymph nodes， all from our hospital. The clinicopathologic features of the two groups were compared. Results There were statistically significant differences in tumor grade （χ²=6.09， P=0.014）， lymph vascular space invasion （P=0.012） and myometrial invasion （χ²=9.66， P=0.002） between the two groups. However， there was no significant difference in histological type between the two groups （χ²=0.19， P=0.661）. Conclusion There is a risk of false negative for sentinel lymph node biopsy in patients with endometrial carcinoma with high-grade tumor， myometrial invasion ≥1/2 and lymph vascular space invasion.

Key words: Endometrial neoplasms, Sentinel lymph node, Sentinel lymph node biopsy, False negative reaction