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[喉癌和下咽癌患者前哨淋巴结的临床研究]

[Clinical study of the sentinel lymph node of patients with laryngeal and hypopharyngeal carcinomas].

作者信息

Fang J, Wei X, Li S, Wang C, Tian A, Tao Y, Sun X, Zou S, Li M, Cai S, Luan X

机构信息

Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan 250012, China.

出版信息

Zhonghua Er Bi Yan Hou Ke Za Zhi. 2001 Aug;36(4):244-6.

Abstract

OBJECTIVE

To investigate the methods of detecting the sentinel lymph node of laryngeal and hypopharyngeal carcinomas and its predictive value in the cervical metastasis of the carcinoma.

METHODS

In 29 patients who suffered from laryngeal or hypopharyngeal carcinoma with NO neck, the patent blue was injected into the surrounding tissue of the tumor during the operation to identify the sentinel lymph nodes. The sentinel lymph nodes were dyed blue. The frozen histopathology was done during the operation, the lymph nodes at the ipsilateral side of the neck were dissected completely, and the routine histopathology was done as the gold standard to study the predictive value of the sentinel lymph node in the metastasis of the cervical node.

RESULTS

Of 29 patients, 28 patients' sentinel lymph nodes were detected successfully during operation. There was an average of 2.5 lymph nodes per side per patient. Most of the sentinel lymph nodes were in the level II and level III regions of the ipsilateral side of the neck, and there were bilateral sentinel nodes in patients suffered from superglottic carcinoma. Three patients' sentinel lymph nodes were found to be positive in the frozen inspection, and the routine histopathology confirmed the result. The micrometastasis rate was 10.7% (3/28). There were no metastatic lymph nodes found in patients who were negative for the sentinel lymph nodes during the operative frozen histopathology. The predicted value of the sentinel lymph nodes to the cervical lymph node metastasis was 100 per cent.

CONCLUSION

There is a very important predicted value of sentinel lymph nodes in the cervical metastasis of patients suffered from laryngeal and hypopharyngeal carcinomas. It could reduce the neck dissection in patients with laryngeal and hypopharyngeal carcinomas.

摘要

目的

探讨喉癌和下咽癌前哨淋巴结的检测方法及其对癌颈部转移的预测价值。

方法

对29例无颈部淋巴结转移的喉癌或下咽癌患者,术中向肿瘤周围组织注射专利蓝以识别前哨淋巴结。前哨淋巴结被染成蓝色。术中进行冰冻组织病理学检查,完整切除患侧颈部淋巴结,以常规组织病理学检查结果作为金标准,研究前哨淋巴结对颈部淋巴结转移的预测价值。

结果

29例患者中,28例患者术中成功检测到前哨淋巴结。平均每位患者每侧有2.5个淋巴结。大多数前哨淋巴结位于患侧颈部Ⅱ区和Ⅲ区,声门上癌患者存在双侧前哨淋巴结。3例患者的前哨淋巴结在冰冻检查中呈阳性,常规组织病理学检查证实了该结果。微转移率为10.7%(3/28)。术中冰冻组织病理学检查前哨淋巴结阴性的患者未发现转移淋巴结。前哨淋巴结对颈部淋巴结转移的预测价值为100%。

结论

前哨淋巴结对喉癌和下咽癌患者的颈部转移具有非常重要的预测价值。它可以减少喉癌和下咽癌患者的颈部清扫术。

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