Department of Head and Neck Surgery, Kyoundo Hospital Sasaki Foundation, Tokyo, Japan.
Jpn J Clin Oncol. 2010 Jun;40(6):537-41. doi: 10.1093/jjco/hyp197. Epub 2010 Feb 4.
We sometimes experienced patients with primary unknown cervical lymph node metastasis. In such cases, if computed tomography, magnetic resonance imaging, laryngoscopy and gastrointestinal endoscopy cannot detect a primary site, there is no other effective method to identify a possible primary tumor. We investigated whether narrow-band imaging can detect a possible primary tumor in such.
Forty-six patients with primary unknown cervical lymph node metastasis were surveyed about primary tumors, from January 2003 to December 2006. All cervical lymph nodes were histologically proved to be squamous cell carcinoma by fine-needle aspiration cytology. Narrow-band imaging combined with magnifying endoscopy was used to identify the primary site in the head and neck region and cervical esophagus. Histological analysis was performed for all suspicious lesions by a biopsy specimen.
Twenty-six lesions were suspected to be cancerous lesions by narrow-band imaging in the head and neck region. Sixteen lesions in 16 (35%, 16/46) patients were squamous cell carcinoma. Ten lesions were located in the hypopharynx and the remaining six lesions were located in the oropharynx. White light endoscopy could not point out any lesion.
Narrow-band imaging endoscopy can detect possible primary cancer in patients with primary unknown cervical lymph node metastasis.
我们有时会遇到原发性不明颈部淋巴结转移的患者。在这种情况下，如果计算机断层扫描、磁共振成像、喉镜和胃肠内窥镜检查不能发现原发性肿瘤，就没有其他有效的方法来识别可能的原发性肿瘤。我们研究了窄带成像是否可以在这种情况下检测到可能的原发性肿瘤。
2003 年 1 月至 2006 年 12 月，我们对 46 例原发性不明颈部淋巴结转移的患者进行了关于原发性肿瘤的调查。所有颈部淋巴结均经细针穿刺细胞学检查证实为鳞状细胞癌。采用窄带成像联合放大内窥镜检查来识别头颈部和颈段食管的原发性肿瘤。对所有可疑病变均进行活检组织学分析。
窄带成像在头颈部怀疑有 26 处癌性病变。16 例（35%，16/46）患者中有 16 个部位（共 16 个部位）发现鳞状细胞癌。10 个病变位于下咽，其余 6 个病变位于口咽。白光内窥镜无法指出任何病变。
窄带成像内窥镜可以检测到原发性不明颈部淋巴结转移患者的可能原发性癌症。
