Kaya İsa, Göde Sercan, Öztürk Kerem, Turhal Göksel, Aliyev Araz, Akyıldız Serdar, Duygun Ülkem Yararbaş, Uluöz Ümit, Yavuzer Atilla
Department of Otorhinolaryngology, Ege University Faculty of Medicine, İzmir, Turkey.
Department of Nuclear Medicine, Ege University Faculty of Medicine, İzmir, Turkey.
Turk Arch Otorhinolaryngol. 2015 Jun;53(2):62-66. doi: 10.5152/tao.2015.1178. Epub 2015 Jun 1.
The aim of this study was to establish the effectiveness of sentinel lymph node biopsy in the detection of metastasis in N0 necks of T1-T2 early-stage oral cavity cancers.
Twenty neck dissections were performed in 18 patients diagnosed with T1 and T2 oral cavity cancer, with an indication for elective neck dissection between November 2007 and January 2011. The male to female ratio was 12:8, with a mean age of 54.5 years (range 28-76). Eight of the dissections were performed for lower lip cancer, 7 for tongue cancer, and 5 for floor of the mouth cancer. Sentinel lymph node biopsy was used to detect metastatic lymph nodes. Tc99m radionuclide injection was administered to the periphery of the tumor 24 h before the operation, and a lymphoscintigraphy image was obtained 30 min after the injection. Sentinel lymph nodes were localized and excised on the day of surgery using static lymphoscintigraphy images and a gamma probe. Sentinel lymph nodes were sent for a frozen section examination, and either a selective or a comprehensive neck dissection was performed for each neck according to the results.
After the final histopathological examination of the specimens, the negative predictive value, the positive predictive value, the accuracy of the sentinel lymph node biopsy, and frozen section accuracy were found to be 100%.
Sentinel lymph node biopsy was found to be an efficient method in the pathological staging and management of the N0 neck in early T-stage oral cavity cancers.
本研究旨在确定前哨淋巴结活检在检测T1 - T2期早期口腔癌N0颈部转移灶方面的有效性。
对18例诊断为T1和T2期口腔癌的患者进行了20次颈部清扫术，这些患者在2007年11月至2011年1月期间有选择性颈部清扫的指征。男女比例为12:8，平均年龄54.5岁（范围28 - 76岁）。其中8次清扫术针对下唇癌，7次针对舌癌，5次针对口底癌。采用前哨淋巴结活检来检测转移性淋巴结。术前24小时向肿瘤周边注射Tc99m放射性核素，注射后30分钟获取淋巴闪烁显像图像。在手术当天，利用静态淋巴闪烁显像图像和γ探针定位并切除前哨淋巴结。将前哨淋巴结送去做冰冻切片检查，然后根据结果对每个颈部进行选择性或根治性颈部清扫。
对标本进行最终组织病理学检查后，发现前哨淋巴结活检的阴性预测值、阳性预测值、准确性以及冰冻切片准确性均为100%。
在前哨T期口腔癌的N0颈部病理分期和管理中，前哨淋巴结活检是一种有效的方法。
