Department of Head and Neck Surgery and Otolaryngology, Asahi University Hospital.
Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University.
Fukushima J Med Sci. 2020 Dec 10;66(3):143-147. doi: 10.5387/fms.2020-17. Epub 2020 Dec 2.
The aim of this supplemental study of a sentinel node (SN) biopsy (SNB) trial for oral squamous cell carcinoma (OSCC) was to assess the effectiveness in identifying micrometastasis and determining whether elective neck dissection (END) is necessary.
Twenty-three patients with pathologically positive SNs were included. The sizes of the metastatic lesions in positive SNs (SMSNs) were classified and the rates of occult metastasis of non-SNs were compared.
The patients were divided according to the SMSN:<0.2 mm (group A, n=3);0.2 mm to <2.0 mm (group B, n=7);and ≥2.0 mm (group C, n=13). The rates of occult metastasis in groups A, B, and C were 0% (0/3), 14% (1/7) and 23% (3/13), respectively.
Rare cancer cell distribution to nodes other than SNs was observed in the patients with SN metastatic lesions of at least smaller than 0.2 mm in size, suggesting the possibility of defining SN micrometastasis in N0 OSCC.
本研究为口腔鳞状细胞癌（OSCC）前哨淋巴结活检（SNB）试验的补充研究，旨在评估识别微转移的有效性，并确定是否需要选择性颈部清扫术（END）。
共纳入 23 例 SN 病理阳性的患者。对阳性 SN 中的转移病灶（SMSN）大小进行分类，并比较非 SN 隐匿性转移的发生率。
患者根据 SMSN 大小分为：<0.2mm（A 组，n=3）；0.2mm 至 <2.0mm（B 组，n=7）；≥2.0mm（C 组，n=13）。A、B、C 组隐匿性转移率分别为 0%（0/3）、14%（1/7）和 23%（3/13）。
在 SN 转移病灶至少小于 0.2mm 的患者中，观察到除 SN 以外的淋巴结中罕见的癌细胞分布，这提示在 N0 OSCC 中可能可以定义 SN 微转移。
