Mrzena L, Betka J, Stárek I, Táborská K, Kodetová D, Krízová H
Klinika ORL a chirurgie hlavy a krku 1 LF UK a FNM, Praha.
Cas Lek Cesk. 2006;145(5):393-8.
The aim of our study was to assess feasibility and accuracy of sentinel lymph node biopsy in patients with head and neck squamous cell carcinoma with clinically N0 neck.
The sentinel lymph node was localised preoperatively by lymphoscintigraphy and intraoperatively by hand-held gamma probe after peritumoral injection of a Tc99m-labeled colloidal human serum albumin. The histology of the sentinel lymph node was compared with the histology of the nodes of the elective neck dissection performed in all patients. 27 patients with oral and oropharyngeal carcinomas accessible to injection in local anaesthesia were enrolled into a prospective trial between July 1993 and December 2005. The sentinel lymph node was localised by preoperative lymphoscintigraphy in 26 of 27 patients. Sentinel lymph node was identified perioperatively by hand-held gamma probe in all 28 necks of 27 patients. Occult metastases were found in 4 sentinel lymph nodes in 4 cases. In one case (3.6 %) the result of sentinel lymph node biopsy was false negative. The sentinel lymph node biopsy correctly predicted the positivity and negativity of the neck in 27 of 28 cases (96.4 %).
Sentinel lymph node biopsy in patients with oral and oropharyngeal carcinomas is feasible and seems to accurately predict the status of the regional lymph nodes.
我们研究的目的是评估前哨淋巴结活检在临床颈部淋巴结阴性的头颈部鳞状细胞癌患者中的可行性和准确性。
术前通过淋巴闪烁显像定位前哨淋巴结，术中在肿瘤周围注射锝-99m标记的胶体人血清白蛋白后，使用手持γ探测器定位。将前哨淋巴结的组织学与所有患者进行的选择性颈部清扫术中淋巴结的组织学进行比较。1993年7月至2005年12月，27例可在局部麻醉下注射的口腔和口咽癌患者纳入一项前瞻性试验。27例患者中有26例通过术前淋巴闪烁显像定位了前哨淋巴结。27例患者的28个颈部在围手术期均通过手持γ探测器识别出前哨淋巴结。4例患者的4个前哨淋巴结发现隐匿性转移。1例（3.6%）前哨淋巴结活检结果为假阴性。前哨淋巴结活检在28例中有27例（96.4%）正确预测了颈部淋巴结的阳性和阴性情况。
口腔和口咽癌患者的前哨淋巴结活检是可行的，似乎能准确预测区域淋巴结的状态。
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