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前哨淋巴结活检可替代小T1期口腔鳞状细胞癌患者的观察等待策略。

Sentinel lymph node biopsy as an alternative to wait and see policy in patients with small T1 oral cavity squamous cell carcinoma.

作者信息

Keski-Säntti Harri, Kontio Risto, Leivo Ilmo, Törnwall Jyrki, Mätzke Sorjo, Mäkitie Antti A, Atula Timo

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Acta Otolaryngol. 2008 Jan;128(1):98-102. doi: 10.1080/00016480701362002.

Abstract

CONCLUSION

Although sentinel lymph node (SLN) biopsy is not yet validated for clinical use to replace elective neck dissection in patients with oral squamous cell carcinoma, it can be recommended for patients who do not fulfil the criteria for elective neck treatment according to current treatment protocols.

OBJECTIVE

To examine the benefits of SLN biopsy in oral cancer patients who have a small risk for occult metastasis and therefore are not considered candidates for elective neck treatment.

PATIENTS AND METHODS

Thirteen consecutive patients with a small T1 oral cavity squamous cell carcinoma, clinically staged NO, and who did not meet the indications for elective neck treatment, underwent SLN biopsy. The SLNs were cut at 1-2 mm intervals and stained with haematoxylin and eosin and cytokeratin AE1/AE3.

RESULTS

Histopathological examination of SLNs revealed micrometastases in two patients. A selective neck dissection was performed on these patients and no further metastases were encountered. All patients had a minimum follow-up of 12 months and no cervical or other recurrences were encountered.

摘要

结论

尽管前哨淋巴结(SLN)活检尚未被证实可在临床中用于替代口腔鳞状细胞癌患者的选择性颈部清扫术,但对于那些不符合现行治疗方案中选择性颈部治疗标准的患者,可推荐采用该方法。

目的

探讨前哨淋巴结活检对于隐匿转移风险较小、因此不被视为选择性颈部治疗候选对象的口腔癌患者的益处。

患者与方法

连续13例患有小T1期口腔鳞状细胞癌、临床分期为N0且不符合选择性颈部治疗指征的患者接受了前哨淋巴结活检。前哨淋巴结以1 - 2毫米的间隔切开,并用苏木精和伊红以及细胞角蛋白AE1/AE3进行染色。

结果

前哨淋巴结的组织病理学检查显示两名患者存在微转移。对这些患者进行了选择性颈部清扫术,未发现进一步转移。所有患者至少随访12个月,未发现颈部或其他复发情况。

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