用颈淋巴显像检测N_0期口腔癌患者颈前哨淋巴结

The value of lymphoscintigraphy for cervical sentinel lymph node detection in patients with clinically N_0 oral squamous cell carcinoma

目的 评价颈淋巴显像检测口腔癌患者前哨淋巴结 (SLN)的价值。方法 2 1例临床N0 期口腔癌患者术前行颈淋巴显像与术中蓝染法检测SLN ,结果与组织学检查比较。结果 ①淋巴显像检测SLN的灵敏度为 10. 0 % (2 1 2 1例 ) ,蓝染法为 85 % (17 2 0例 )。②SLN活组织检查和颈淋巴结清扫术均证实 33. 3% (7 2 1例 )患者有颈淋巴结转移 ,准确性 10. 0 % ;活组织检查阴性者 14例 ,颈淋巴结清扫术亦为阴性 ,特异性 10 .0 %。结论 淋巴显像能有效检测口腔癌患者的SLN ,准确预测颈淋巴结转移情况。

Objective To evaluate the value of lymphoscintigraphy for cervical sentinel lymph node (SLN) detection in patients with oral squamous cell carcinoma. Methods Twenty-one patients with clinically N 0 oral squamous carcinoma underwent preoperative lymphoscintigraphy and intraoperative methylene blue location. The results were compared with pathological findings. Results ①The sensitivity of lymphoscintigraphy for detecting SLN was 100%(21/21),and methylene blue was 85% (17/20). ②Both SLN biopsy and cervical ablative dissection confirmed that 33.3% (7/21) patients were with cervical lymph node metastasis. Fourteen non-metastatic SLNs comfirmed by biopsy were also proved with the findings of neck dissection, and the specificity was 100%. Conclusion Lymphoscintigraphy can detect the cervical SLN and accurately predict cervical lymph node metastasis in patients with oral squamous cell carcinoma.