Atula Timo, Shoaib Taimur, Ross Gary L, Gray Henry W, Soutar David S
Canniesburn Plastic Surgery Unit, Jubilee Building, Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
Eur Arch Otorhinolaryngol. 2008 Jul;265 Suppl 1(Suppl 1):S19-23. doi: 10.1007/s00405-007-0548-x. Epub 2007 Dec 19.
The number of harvested lymph nodes when performing sentinel lymph node (SLN) biopsy remains controversial. The aim of this study was to examine the maximum number of nodes to be harvested for histopathological analysis. We also wanted to determine if the level of radioactivity within a SLN or its size were indicators for the likelihood of nodal metastases. The SLNs from 34 neck dissection specimens from patients with T1/T2 N0 oral and oropharyngeal carcinomas were included. Altogether 76 SLNs were measured for radioactivity and lymph node dimensions and volume. Tumour was identified in 16 of 76 nodes (positive nodes), and the remaining 60 nodes were free from tumour (negative nodes). In 9 of 16 cases, metastases were in the hottest node. Two patients had more than one positive SLN: the first and fourth hottest in one and the second and fourth hottest nodes in another contained tumour. However, all patients would have been staged accurately if only the hottest three sentinel nodes had been retrieved. Lymph nodes that contained tumour had a greater maximum diameter than non-metastatic SLNs. To stage the neck accurately, only the three hottest lymph nodes required sampling.
进行前哨淋巴结（SLN）活检时获取的淋巴结数量仍存在争议。本研究的目的是检查用于组织病理学分析的淋巴结最大获取数量。我们还想确定SLN内的放射性水平或其大小是否为淋巴结转移可能性的指标。纳入了34例T1/T2 N0口腔和口咽癌患者颈部清扫标本中的SLN。总共对76个SLN进行了放射性、淋巴结尺寸和体积的测量。76个淋巴结中有16个发现肿瘤（阳性淋巴结），其余60个淋巴结无肿瘤（阴性淋巴结）。在16例中的9例中，转移灶位于放射性最强的淋巴结。两名患者有不止一个阳性SLN：其中一名患者的第一个和第四个放射性最强的淋巴结以及另一名患者的第二个和第四个放射性最强的淋巴结含有肿瘤。然而，如果仅获取三个放射性最强的前哨淋巴结，所有患者的分期都将准确无误。含有肿瘤的淋巴结最大直径大于无转移的SLN。为准确进行颈部分期，仅需对三个放射性最强的淋巴结进行采样。
