摘要
目的 探讨头颈部肿瘤前哨淋巴结的检测及其对颈淋巴结转移的预测价值。方法 用手术中注射蓝染料的方法 ,对 5 1例未经治疗的头颈部癌颈淋巴结N0的患者进行了手术中前哨淋巴结的临床研究。手术中取前哨淋巴结作快速冰冻病理 ,并与手术后常规石蜡切片病理对照 ,观察冰冻病理前哨淋巴结转移与常规病理颈淋巴结转移的相关性及其对颈淋巴结转移癌的预测值。结果 5 1例中 48例成功的显示了前哨淋巴结 ,成功率 94 1% ,前哨淋巴结平均每例每侧 2 5枚。 11例前哨淋巴结阳性 ,其中 2例有前哨淋巴结以外的颈淋巴结转移 ,2例为假阴性。前哨淋巴结对颈淋巴结转移的总阳性预测值为 85 %。结论 前哨淋巴结检测对头颈部癌的颈淋巴结转移有重要的预测价值。
Objective By performing sentinel lymph node (SLN) biopsy, its detecting and predictive value to the cervical metastasis in the head and neck cancer patients was studied. Methods Intraoperative SLN biopsy was done in 51 untreated head and neck cancer patients who all had no metastasis before operation. The lesions were: laryngeal cancer 23, pharyngeal cancer 6, thyroid cancer 20 and cancer of the tongue 2. Fifteen minutes before taking the SLN, local 0.2 to 0.5 ml 2% isosulfan blue dye was submucously injected 0.5 cm away from the upper, lower, right and left margin of the primary tumor. The frozen sections of SLN were compared with the routine pathological sections of the cervical lymph nodes. The metastatic relation between the SLN and the cervical nodes as well as SLN′s predictive value to the cervical nodes metastasis were analyzed.Results SLN was successfully revealed in 48 (94%) of these 51 patients, averaging 2.5 nodes per patient. They were: laryngeal cancer 22, pharyngeal cancer 6, thyroid cancer 18 and lingual cancer 1. Eleven of these SLNs were positive, among whom two had lymph node metastasis in addition to the SLN. Two others were false negative. The positive predictive value of SLNs to the cervical lymph node metastasis was 85%.Conclusion The predictive value of sentinel lymph node to the cervical metastasis is important in head and neck cancer patients. [
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2001年第5期431-433,共3页
Chinese Journal of Oncology
关键词
头颈部肿瘤
病理学
淋巴转移
前哨淋巴结
外科手术
Head and neck neoplasms/pathology
Head and neck neoplasms/surgery
Lymphatic metastasis
