头颈部鳞状细胞癌中前哨淋巴结识别失败的预测因素。

Predictive factors for failure to identify sentinel nodes in head and neck squamous cell carcinoma.

作者信息

Hornstra Marije T, Alkureishi Lee W T, Ross Gary L, Shoaib Taimur, Soutar David S

机构信息

Plastic Surgery Unit, Canniesburn Hospital, Glasgow Royal Infirmary, Glasgow, United Kingdom.

出版信息

Head Neck. 2008 Jul;30(7):858-62. doi: 10.1002/hed.20787.

DOI:10.1002/hed.20787

PMID:18302276

Abstract

BACKGROUND

The aim of this study was to ascertain which factors determine success of sentinel node biopsy (SNB).

METHODS

We conducted a retrospective review of 121 patients with head and neck squamous cell carcinoma undergoing SNB to stage the neck. All patients underwent the triple-diagnostic procedure of preoperative lymphoscintigraphy, intraoperative blue dye, and a gamma probe. Factors contributing to failure of SNB were identified.

RESULTS

SNB was unsuccessful in 12 of 121 patients (10%). Seven of the 12 patients had cT1/cT2 tumors, and 6 of these were located in the floor of mouth. SN identification was more likely to be successful in patients with cN0 necks, but this did not reach statistical significance (92% vs 84%, p = .268). Factors associated with failure included T classification (p = .01), tumor site (p = .05), and negative preoperative lymphoscintigraphy (p = .0174).

CONCLUSION

Successful sentinel lymph node harvest is related to primary tumor site, T classification, and the presence of nodes on preoperative lymphoscintigraphy.

摘要

背景

本研究的目的是确定哪些因素决定前哨淋巴结活检（SNB）的成功。

方法

我们对121例行SNB以进行颈部分期的头颈部鳞状细胞癌患者进行了回顾性研究。所有患者均接受了术前淋巴闪烁显像、术中蓝色染料和γ探针的三联诊断程序。确定了导致SNB失败的因素。

结果

121例患者中有12例（10%）SNB未成功。12例患者中有7例为cT1/cT2肿瘤，其中6例位于口底。cN0颈部患者的前哨淋巴结识别更有可能成功，但未达到统计学意义（92%对84%，p = 0.268）。与失败相关的因素包括T分类（p = 0.01）、肿瘤部位（p = 0.05）和术前淋巴闪烁显像阴性（p = 0.0174）。