Background/Objectives: Lymph node (LN) assessment for cases of endometrial intraepithelial neoplasia (EIN), a known precursor to endometrial cancer (EC), is a topic of debate. Some experts believe this practice could avoid re-staging of disease and influence the decision to administer adjuvant treatment. However, it is known that obtaining sentinel lymph node (SLN) biopsies in patients with an elevated body mass index (BMI) can be more challenging. We thus sought to evaluate the effect of BMI on the SLN detection rate (DR) during robotic hysterectomy in EIN cases.Methods: We conducted a retrospective chart review for patients with a pre-operative diagnosis of EIN who underwent robotic hysterectomy with SLN sampling. Five BMI categories were determined according to the literature. Distribution normality was assessed with the Kolmogorov–Smirnov test. Continuous variables, non-parametric continuous variables and categorical variables were assessed with the appropriate statistical tests (two-tailed Student’st-tests, Mann–Whitney U-tests, and chi-squared tests, respectively).Results: 115 patients were included (average BMI of 34.75 ± 9.38 SD). The bilateral SLN DR was not significantly different between BMI groups (p= 0.606). The difference in unilateral SLN DR between BMI groups was also non-significant (p= 0.269). When examining high BMI subgroups (BMI > 30 and BMI > 40), no significant difference was found in bilateral nor unilateral SLN DR. A logistic regression model showed that for every unit of BMI, the likelihood of SLN DR did not change significantly.Conclusions: We found no connection between obesity (BMI > 30) or morbid obesity (BMI > 40) and reduced SLN DR in EIN cases, nor a significant variation in the DR when comparing all the different BMI subgroups.
背景/目的：对于子宫内膜上皮内瘤变（EIN）这一已知的子宫内膜癌前病变，是否进行淋巴结评估存在争议。部分专家认为该操作可避免疾病再分期，并影响辅助治疗决策。然而，已知在体重指数（BMI）较高的患者中获取前哨淋巴结活检更具挑战性。本研究旨在评估EIN病例行机器人子宫切除术时，BMI对前哨淋巴结检出率的影响。 方法：我们对术前诊断为EIN并接受机器人子宫切除术联合前哨淋巴结取样的患者进行回顾性病历分析。根据文献将BMI分为五类。采用Kolmogorov-Smirnov检验评估数据分布正态性，连续变量、非参数连续变量和分类变量分别采用双尾Student t检验、Mann-Whitney U检验和卡方检验进行统计分析。 结果：共纳入115例患者（平均BMI为34.75±9.38标准差）。不同BMI组间的双侧前哨淋巴结检出率无显著差异（p=0.606），单侧检出率差异亦不显著（p=0.269）。对高BMI亚组（BMI>30及BMI>40）进行分析时，双侧及单侧前哨淋巴结检出率均未发现显著差异。逻辑回归模型显示，BMI每增加一个单位，前哨淋巴结检出率未发生显著变化。 结论：本研究发现，在EIN病例中，肥胖（BMI>30）或病态肥胖（BMI>40）与前哨淋巴结检出率降低无显著关联，不同BMI亚组间的检出率亦无显著差异。
肿瘤(癌症)患者之家