Chaturvedi Pankaj, Datta Sourav, Arya Supreeta, Rangarajan Venkatesh, Kane Shubhada V, Nair Deepa, Nair Sudhir, Chaukar Devendra A, Pai Prathamesh S, Pantvaidya Gouri, Deshmukh Anuja D, Agrawal Archi, D'Cruz Anil K
Department of Head and Neck Surgery, Tata Memorial Centre, Parel, Mumbai, India.
Department of Radiology, Tata Memorial Centre, Parel, Mumbai, India.
Head Neck. 2015 Oct;37(10):1504-8. doi: 10.1002/hed.23787. Epub 2014 Jul 21.
The purpose of this study was to compare sentinel node biopsy (SNB) and ultrasound-guided fine-needle aspiration cytology (FNAC) for preoperative evaluation of the N0 neck in T1 to T2 oral cavity squamous cell carcinoma (SCC).
Fifty-one consecutive patients with T1 to T2 N0 oral cavity SCC were included in this study. Preoperative ultrasound was performed in all patients. Ultrasound-guided FNAC was performed in patients in whom the ultrasound result was reported as indeterminate or positive. SNB was done in all patients followed by elective neck dissection (END). Histopathology of END was considered as the gold standard for all statistical analysis.
The incidence of occult metastasis was 26.4%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 71.4%, 100%, 100%, and 90.2% for SNB and 14.3%, 100%, 100%, and 76.5% for ultrasound-guided FNAC.
Ultrasound-guided FNAC lacked sufficient accuracy to detect occult metastases. SNB is a reliable method to detect occult metastasis that has potential to replace END.
本研究旨在比较前哨淋巴结活检（SNB）和超声引导下细针穿刺细胞学检查（FNAC）对T1至T2期口腔鳞状细胞癌（SCC）颈部N0状态的术前评估价值。
本研究纳入51例连续的T1至T2期N0口腔SCC患者。所有患者术前行超声检查。超声检查结果为不确定或阳性的患者接受超声引导下FNAC。所有患者均行SNB，随后行选择性颈清扫术（END）。END的组织病理学检查结果被视为所有统计分析的金标准。
隐匿性转移的发生率为26.4%。SNB的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为71.4%、100%、100%和90.2%，超声引导下FNAC的分别为14.3%、100%、100%和76.5%。
超声引导下FNAC检测隐匿性转移的准确性不足。SNB是检测隐匿性转移的可靠方法，并有可能取代END。
