Marttila E, Keski-Säntti H, Hagström J, Snäll J, Wilkman T
Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 Helsinki.
Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, PO Box 263, FI-00029 Helsinki.
Br J Oral Maxillofac Surg. 2020 Nov;58(9):1078-1083. doi: 10.1016/j.bjoms.2020.05.022. Epub 2020 Jun 7.
The aim of this retrospective study was to analyse a consecutive series of patients with oral and oropharyngeal carcinoma who had had sentinel lymph node biopsy (SLNB) at our hospital during 2008-2017. A total of 70 patients with clinically and radiologically confirmed primary oral (n=67) or oropharyngeal (n=3) carcinoma, with no signs of metastatic lymph nodes preoperatively (clinically N0) were included. Patients' clinical and personal data, characteristics of the tumours, sentinel lymph node (SLN) status and outcomes were recorded. Eight patients had invaded SLN. Two patients with clear sentinel lymph node biopsies had recurrences in the cervical lymph nodes with no new primary tumour as origin. The negative predictive value (NPV) and sensitivity for SLNB were 97% and 80%, respectively. The depth of invasion was an individual predictor for cervical lymph node metastasis (p=0.043). Single photo emission computed tomography (SPECT) detected fewer SLN in patients with invaded lymph nodes than in patients with clear lymph nodes (p=0.018). Our data support the use of SLNB as a minimally invasive method for staging the cervical lymph nodes among patients with cN0 oral and oropharyngeal carcinoma. Our results further confirm that greater depth of invasion is associated with cervical lymph node metastases.
本回顾性研究的目的是分析2008年至2017年期间在我院接受前哨淋巴结活检（SLNB）的一系列连续性口腔和口咽癌患者。总共纳入了70例临床和影像学确诊的原发性口腔癌（n = 67）或口咽癌（n = 3）患者，术前均无转移性淋巴结迹象（临床N0）。记录患者的临床和个人资料、肿瘤特征、前哨淋巴结（SLN）状态及预后情况。8例患者的前哨淋巴结受到侵犯。2例前哨淋巴结活检结果为阴性的患者，其颈部淋巴结复发，且无新的原发性肿瘤作为起源。SLNB的阴性预测值（NPV）和敏感性分别为97%和80%。浸润深度是颈部淋巴结转移的个体预测因素（p = 0.043）。单光子发射计算机断层扫描（SPECT）检测到淋巴结受侵患者的前哨淋巴结数量少于淋巴结未受侵患者（p = 0.018）。我们的数据支持将SLNB作为cN0口腔和口咽癌患者颈部淋巴结分期的微创方法。我们的结果进一步证实，浸润深度增加与颈部淋巴结转移相关。
