Background/Objectives: Endometrial hyperplasia is a uterine pathology characterized by the abnormal proliferation of endometrial glands, resulting in an increased gland-to-stroma ratio. Complex atypical hyperplasia represents the primary precursor to endometrial cancer. Given the high risk of progression to endometrial adenocarcinoma, the accurate diagnosis and classification of endometrial hyperplasia are crucial. Since the treatment for atypical endometrial hyperplasia is the same as that for early-stage endometrial cancer (i.e., total hysterectomy and bilateral salpingo-oophorectomy), researchers have questioned whether sentinel lymph node mapping could also have a prognostic role in atypical endometrial hyperplasia.Methods: A literature search was conducted in PubMed and Scopus from 2014 to 2025. Of the 65 papers found, 31 relevant articles were selected based on inclusion criteria, focusing on sentinel lymph node staging in patients with atypical endometrial hyperplasia. This review aims to assess whether sentinel lymph node mapping can be routinely used for prognostic and therapeutic purposes in clinical practice.Results: Sentinel lymph node biopsy represents a promising diagnostic technique for patients with atypical endometrial hyperplasia, reducing the need for invasive procedures and postoperative risks. However, its application requires advanced surgical skills and access to specific technologies, raising ethical and financial concerns, while future studies could improve patient selection and the reliability of the procedure through technological innovations.Conclusions: Sentinel lymph node biopsy is a safe and effective method for staging early-stage endometrial cancer and atypical hyperplasia, with low metastasis rates, but future research should focus on identifying patients who would benefit most from this procedure, considering its costs and required expertise.
背景/目的：子宫内膜增生是一种以子宫内膜腺体异常增殖为特征的子宫病变，表现为腺体与间质比例增高。复杂性非典型增生是子宫内膜癌的主要癌前病变。鉴于其进展为子宫内膜腺癌的高风险，子宫内膜增生的准确诊断与分类至关重要。由于非典型子宫内膜增生的治疗方案与早期子宫内膜癌相同（即全子宫切除加双侧输卵管卵巢切除术），研究者开始探讨前哨淋巴结定位是否也能在非典型子宫内膜增生中发挥预后评估作用。 方法：在PubMed和Scopus数据库中检索2014年至2025年的文献。从检索到的65篇论文中，根据纳入标准筛选出31篇相关文献，重点关注非典型子宫内膜增生患者的前哨淋巴结分期研究。本综述旨在评估前哨淋巴结定位能否作为常规预后评估和治疗指导手段应用于临床实践。 结果：前哨淋巴结活检对非典型子宫内膜增生患者是一种具有前景的诊断技术，可减少侵入性操作需求和术后风险。然而，该技术的应用需要高超的手术技巧和特定技术支持，引发了伦理与费用方面的考量，而未来研究可通过技术创新优化患者选择并提升操作可靠性。 结论：前哨淋巴结活检是早期子宫内膜癌及非典型增生分期安全有效的方法，其淋巴结转移率较低。但考虑到操作成本和技术要求，未来研究应着重识别最能从此项技术中获益的患者群体。
Sentinel Lymph Node in Endometrial Hyperplasia: State of the Art and Future Perspectives
肿瘤(癌症)患者之家