Sen Ersin, Basut Oğuz, Oztürk Idil, Demir Uygar Levent, Ozmen Omer Afşın, Kasapoğlu Fikret, Durgut Osman
Uludağ Universitesi Tip Fakültesi, Kulak Burun Boğaz Hastaliklari Anabilim Dali, Bursa, Türkiye.
Kulak Burun Bogaz Ihtis Derg. 2012 Mar-Apr;22(2):81-6. doi: 10.5606/kbbihtisas.2012.015.
This study aims to evaluate the role of sentinel lymph node (SLN) biopsy in patients who had clinically N0 oral cavity cancer in the neck assessment.
Between May 2006 and May 2008, nine patients with clinically N0 oral cavity cancer (6 females, 3 males; mean age 57±24.7 years; range 31 to 71 years) who underwent surgical treatment were enrolled in this study. Eight of them had corpus linguae carcinoma, while one had lower lip carcinoma. Tumor stages were T1 in four, T2 in four patients, and T4a in one patient. The patients underwent surgery within 8 to 16 hours after lymphoscintigraphy was performed for detecting SLNs. Initially primary tumor was excised. Then, SLNs which were identified by a gamma probe, lifting skin flap of the neck were excised. Neck dissection was performed as scheduled. SLNs were examined in frozen sections. The results of frozen section and definitive histopathological diagnosis of SLNs were compared with each other, as well as the definitive histopathological diagnosis of the dissection materials.
In all patients SLNs were completely identified and excised successfully, including one node in one patient, two nodes in six patients and three nodes in two patients. All nodes were localized ipsilaterally in the neck. In addition, the frozen section and definitive histopathological examination results of all nodes were consistent. Biopsy results indicated that eight patients were SLN-negative, while one was SLN-positive. Only one patient was SLN-negative, although the pathological diagnosis was found to be N1.
Our study results suggests that SLN biopsy may be applicable for early stage oral cavity tumors.
本研究旨在评估前哨淋巴结（SLN）活检在临床颈部淋巴结阴性的口腔癌患者颈部评估中的作用。
2006年5月至2008年5月期间，9例临床颈部淋巴结阴性的口腔癌患者（6例女性，3例男性；平均年龄57±24.7岁；年龄范围31至71岁）接受了手术治疗并纳入本研究。其中8例为舌体癌，1例为下唇癌。肿瘤分期为4例T1期，4例T2期，1例T4a期。患者在进行淋巴闪烁显像以检测前哨淋巴结后8至16小时内接受手术。首先切除原发肿瘤。然后，通过γ探针识别前哨淋巴结，掀起颈部皮瓣后将其切除。按计划进行颈部清扫术。对前哨淋巴结进行冰冻切片检查。将前哨淋巴结的冰冻切片结果和最终组织病理学诊断结果相互比较，同时与清扫标本的最终组织病理学诊断结果进行比较。
所有患者的前哨淋巴结均被成功完全识别并切除，其中1例患者有1个淋巴结，6例患者有2个淋巴结，2例患者有3个淋巴结。所有淋巴结均位于颈部同侧。此外，所有淋巴结的冰冻切片结果与最终组织病理学检查结果一致。活检结果显示，8例患者前哨淋巴结阴性，1例患者前哨淋巴结阳性。尽管病理诊断为N1，但只有1例患者前哨淋巴结阴性。
我们的研究结果表明，前哨淋巴结活检可能适用于早期口腔肿瘤。
