Civantos Francisco, Zitsch Robert, Bared Anthony
Department of Head & Neck, University of Miami, Miami, FL 33136, USA.
J Surg Oncol. 2007 Sep 15;96(4):330-6. doi: 10.1002/jso.20865.
The clinical utility of sentinel node biopsy techniques for cutaneous melanoma has led multiple investigators to study the applicability of this approach to other solid tumors, including cancers of the upper aerodigestive tract, and especially the oral cavity. Preliminary data indicate that it may be useful for early oral cancers, with the exception of floor of mouth tumors, where technical challenges related to the proximity of the lymphatic basin remain a problem. A multi-institutional pathologic validation trial, involving sentinel node biopsy followed by completion selective neck dissection, has completed accrual. While central step sectioning and immunohistochemistry remain to be completed and analyzed, routine pathologic techniques provided negative predictive values of 96% for oral cancer excluding floor of mouth lesions. Subsequent trials need to involve clinical follow-up and evaluation for recurrence in the neck. We believe this technique may ultimately play a role in the management of early oral cancer.
前哨淋巴结活检技术在皮肤黑色素瘤中的临床应用，促使众多研究者研究该方法在其他实体瘤中的适用性，包括上呼吸道消化道癌，尤其是口腔癌。初步数据表明，除口底肿瘤外，该技术可能对早期口腔癌有用，口底肿瘤因淋巴引流区域接近带来的技术挑战仍是个问题。一项多机构病理验证试验已完成入组，该试验包括前哨淋巴结活检，随后进行根治性选择性颈清扫术。虽然中心阶梯切片和免疫组化仍有待完成和分析，但常规病理技术对不包括口底病变的口腔癌提供了96%的阴性预测值。后续试验需要进行临床随访和颈部复发评估。我们认为该技术最终可能在早期口腔癌的治疗中发挥作用。
