Bell R Bryan, Markiewicz Michael R, Dierks Eric J, Gregoire Curtis E, Rader Anne
Oral, Head and Neck Cancer Program, Providence Cancer Center, Robert W. Franz Cancer Research Center, Providence Portland Medical Center, Portland, OR 97213, USA.
J Oral Maxillofac Surg. 2013 Jul;71(7):1268-77. doi: 10.1016/j.joms.2012.12.019. Epub 2013 Feb 27.
PURPOSE: The purpose of this study was to assess the predictability of sentinel lymph node biopsy (SNB) for oral squamous cell carcinoma (OSCC) when pathologic processing is performed without serial step sectioning. MATERIALS AND METHODS: We prospectively enrolled 36 patients with T1 or T2 cN0 OSCC into this institutional review board-approved prospective cohort study, and they underwent gamma probe-guided SNB in addition to selective neck dissection. The rate of patients with negative SNB results whose neck dissection was also negative for metastasis (negative predictive value) was the primary endpoint. RESULTS: Of the 28 patients whose sentinel lymph nodes were found to be pathologically and clinically node negative by routine hematoxylin-eosin stain and immunohistochemistry, 27 were found to have no other pathologically positive nodes, corresponding to a negative predictive value of 96%. CONCLUSION: The results of this study suggest that SNB performed without the use of thin serial step sectioning may accurately predict neck stage in OSCC.
目的：本研究的目的是评估在不进行连续切片病理处理的情况下，前哨淋巴结活检（SNB）对口腔鳞状细胞癌（OSCC）的预测能力。 材料与方法：我们前瞻性地招募了36例T1或T2 cN0 OSCC患者参与这项经机构审查委员会批准的前瞻性队列研究，这些患者除了接受选择性颈清扫术外，还接受了γ探针引导下的SNB。前哨淋巴结活检结果为阴性且颈清扫术也未发现转移的患者比例（阴性预测值）是主要终点。 结果：在28例经常规苏木精-伊红染色和免疫组化检查发现前哨淋巴结在病理和临床检查中均为阴性的患者中，有27例未发现其他病理阳性淋巴结，阴性预测值为96%。 结论：本研究结果表明，不使用薄连续切片进行的前哨淋巴结活检可能准确预测OSCC的颈部分期。
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