Willis Alliric I, Ridge John A
Department of Surgical Oncology, Head and Neck Surgery Section, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Head Neck. 2007 Nov;29(11):979-85. doi: 10.1002/hed.20631.
We analyzed the variability and accuracy of sentinel lymph node (SLN) identification by lymphoscintigraphy performed preoperatively and repeated on the day of operation in patients with melanoma or Merkel cell cancer.
Twenty-five prospectively studied patients had lymphoscintigraphy prior to and on the day of operation. Discordance between lymphoscintograms was defined as change in location of SLN or failure to identify a SLN by one of the studies.
In 22 of 24 assessable cases (92%), SLNs were excised. Preoperative lymphoscintigraphy was correct in 19 of 22 (86%) cases. Day of operation lymphoscintigraphy was correct in 20 of 22 (91%) cases. SLN location was as classically described in 24 of 25 (96%) cases. Discordance between lymphoscintigraphy studies was 32% (8/25 patients). Half with discordant migration (8%) yielded metastases in basins not identified by day of operation lymphoscintigraphy but demonstrated by preoperative lymphoscintigraphy.
Head and neck lymphatic drainage patterns not only vary between patients but also can vary with time for a single patient.
我们分析了黑色素瘤或默克尔细胞癌患者术前进行的淋巴闪烁显像以及手术当天重复进行的淋巴闪烁显像在哨位淋巴结（SLN）识别方面的变异性和准确性。
25例前瞻性研究患者在手术前和手术当天均接受了淋巴闪烁显像。淋巴闪烁显像图之间的不一致定义为SLN位置的改变或其中一项研究未能识别出SLN。
在24例可评估病例中的22例（92%）中，切除了SLN。术前淋巴闪烁显像在22例中的19例（86%）是正确的。手术当天淋巴闪烁显像在22例中的20例（91%）是正确的。25例中的24例（96%）的SLN位置如经典描述。淋巴闪烁显像研究之间的不一致率为32%（8/25例患者）。有迁移不一致情况的患者中有一半（8%）在手术当天淋巴闪烁显像未识别但术前淋巴闪烁显像显示的区域出现转移。
头颈部淋巴引流模式不仅在患者之间存在差异，而且对于单个患者而言也可能随时间变化。
