Cadena-Pineros Enrique, Goìmez-Herrera Juliaìn, Mayo-Patiño Melissa, Carreño Alexander
Department of Head and Neck, National Cancer institute, Bogotá, Colombia.
Department of Otorhinolaryngology, National University of Colombia and National University Hospital of Colombia, Bogotá, Colombia.
Indian J Nucl Med. 2022 Jan-Mar;37(1):43-49. doi: 10.4103/ijnm.ijnm_95_21. Epub 2022 Mar 25.
The aim of this study was to determine the advantages of preoperative sentinel lymph node mapping (SLNM) by single photon emission computed tomography/computed tomography (SPECT / CT) in patients with early-stage cutaneous head-and-neck malignancies.
We conduct a 7-year and 6 months retrospective, cross-sectional study. Patients with early-stage malignant head-and-neck skin tumors and cutaneous adnexa who underwent SLNM by SPECT/CT from March 2012 and December 2019, were included in the study.
We retrospectively analyzed 28 patients: Melanoma was the most frequent tumor (64.2%), followed by squamous cell carcinoma (25%). The anterior cheek was the most common functional subsite (25%). Twenty-seven patients (96.4%) had a successful SLN detection with SPECT/CT. Neck lymph node dissection was performed in 23 patients (82.1%). According to the pathological specimen, lymph nodes were found in all of them; hence, the efficacy of the SPECT/CT for SLNM was 100%. At 7-year follow-up, systemic recurrence was found in one patient (3.6%), another had locoregional recurrence (3.6%), and the mortality rate was 3.6%.
In early-stage malignant head-and-neck skin tumors, there is a high concordance between SLN found by SPECT/CT and the histopathological results. Preoperative SPECT/CT accurately detects the SLN, assesses unexpected lymph nodes and their drainage pathways, and facilitates their location by reliably showing the relationships between sentinel nodes and important anatomic structures. This allows to perform a clear preoperative evaluation, an accurate staging for all patients and to avoid excessive dissections that could result in cosmetic and functional deformities.
本研究旨在确定术前通过单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）进行前哨淋巴结定位（SLNM）在早期头颈部皮肤恶性肿瘤患者中的优势。
我们进行了一项为期7年6个月的回顾性横断面研究。纳入2012年3月至2019年12月期间接受SPECT/CT引导下SLNM的早期头颈部皮肤恶性肿瘤和皮肤附属器肿瘤患者。
我们回顾性分析了28例患者：黑色素瘤是最常见的肿瘤（64.2%），其次是鳞状细胞癌（25%）。面颊前部是最常见的功能亚部位（25%）。27例患者（96.4%）通过SPECT/CT成功检测到前哨淋巴结。23例患者（82.1%）进行了颈部淋巴结清扫。根据病理标本，所有患者均发现有淋巴结；因此，SPECT/CT用于SLNM的有效率为100%。在7年随访中，1例患者出现全身复发（3.6%），另1例出现局部区域复发（3.6%），死亡率为3.6%。
在早期头颈部皮肤恶性肿瘤中，SPECT/CT发现的前哨淋巴结与组织病理学结果高度一致。术前SPECT/CT能准确检测前哨淋巴结，评估意外淋巴结及其引流途径，并通过可靠显示前哨淋巴结与重要解剖结构之间的关系来方便其定位。这有助于进行明确的术前评估、对所有患者进行准确分期，并避免可能导致美容和功能畸形的过度清扫。
