核素显像-染色法探测舌癌前哨淋巴结

Clinical study of the sentinel lymph node detection in tongue cancer with combined isotope-dye technique

目的 探讨核素显像 染色法探测舌癌前哨淋巴结 (SLN)和预测颈淋巴结转移的价值。方法 N0 期舌癌患者 2 0例 ,术前 1d于肿瘤周围组织注射99Tcm 硫胶体 (SC)约 18 5MBq ,分别于 5、10、30、6 0min及 6h时进行显像 ,识别SLN并进行体表定位 ;术中于肿瘤周围注入亚甲蓝 ,据淋巴结蓝染和皮肤定位情况找出SLN ,行冰冻病理检查 ,后常规切除原发灶 ,行选择性颈淋巴清扫并行病理检查 ,以观察其对舌癌颈淋巴结转移的预测价值。结果 该组中未见假阳性和假阴性病例 ,SLN检出率为 10 0 %。结论 核素显像 染色法在舌癌SLN探测与颈淋巴结转移预测中有重要的临床意义。

Objective To investigate the clinical value of combined isotope dye technique for detecting the sentinel lymph node (SLN) and predicting the cervical lymph node metastasis in tongue cancer. Methods Twenty patients with tongue cancer without lymph node metastasis were injected with 99 Tc m sulfur colloid (SC), at a dose of about 18 5 MBq, around the tongue cancer and underwent lymphoscintigraphy before operation. At the next day, all the patients were injected with isosulfan blue dye around the primary tumor during operation to detect the SLN and underwent standard cervical lymph node dissection after SLN detection. SLN detection was compared with standard lymph node dissection for its ability to accurately predict the final pathological status of the cervical lymph nodes. Results The SLN was successfully identified in 100% of the patients. There was no false positive case and no false negative case eihter in this study. Conclusion The detection of SLN with radionuclide imaging and dyeing method could predict accurately the cervical metastasis in tongue cancer and direct the operation scheme.