Sahafi Pegah, Sadeghi Ramin, Askari Emran, Sahebkari Azadeh, Ghahraman Mitra, Khadivi Ehsan, Khazaeni Kamran, Dabbagh Kakhki Vahid Reza, Harsini Sara
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad 9176699199, Iran.
Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad 9176699199, Iran.
Diagnostics (Basel). 2025 Feb 4;15(3):366. doi: 10.3390/diagnostics15030366.
Sentinel lymph node (SLN) biopsy offers a minimally invasive approach to staging lymph node involvement in laryngeal squamous cell carcinoma (SCC). Despite its adoption in other cancers, its accuracy in laryngeal SCC remains under investigation. This systematic review and meta-analysis evaluates the diagnostic performance of SLN mapping in laryngeal cancer. A systematic search of MEDLINE, Scopus, and Google Scholar was conducted using the keywords "(larynx OR laryngeal) AND sentinel", with no date or language restrictions. Studies reporting SLN detection rates and/or sensitivity in laryngeal SCC were included. A random-effects model was applied for data pooling, and subgroup analyses were performed based on tumor location (supraglottic versus transglottic) and mapping material (radiotracer versus blue dye). Publication bias was assessed using funnel plots and statistical methods. Nineteen studies, encompassing 366 patients, were analyzed. The overall pooled SLN detection rate was 90.8% (95% CI: 86-94.1), and sensitivity was 88% (95% CI: 81-94). Supraglottic tumors demonstrated superior outcomes (detection rate: 93.7%, sensitivity: 96%) compared to transglottic tumors (detection rate: 84.7%, sensitivity: 71%). Radiotracers significantly outperformed blue dye, with detection rates of 90.8% versus 81.5% and sensitivities of 88% versus 77%. SLN mapping is a reliable technique for staging laryngeal SCC, particularly for supraglottic tumors, where high detection rates and sensitivity were observed. Radiotracers offer superior performance compared to blue dye, underscoring their clinical value. These findings support the feasibility and accuracy of SLN biopsy in laryngeal cancer, while emphasizing the importance of tumor location and mapping material.
前哨淋巴结（SLN）活检为评估喉鳞状细胞癌（SCC）的淋巴结受累情况提供了一种微创方法。尽管它已被应用于其他癌症，但在喉SCC中的准确性仍在研究中。本系统评价和荟萃分析评估了SLN定位在喉癌中的诊断性能。使用关键词“（喉或喉部）和前哨”对MEDLINE、Scopus和谷歌学术进行了系统检索，无日期或语言限制。纳入报告喉SCC中SLN检出率和/或敏感性的研究。采用随机效应模型进行数据合并，并根据肿瘤位置（声门上型与跨声门型）和定位材料（放射性示踪剂与蓝色染料）进行亚组分析。使用漏斗图和统计方法评估发表偏倚。分析了19项研究，共366例患者。总体合并SLN检出率为90.8%（95%CI：86-94.1），敏感性为88%（95%CI：81-94）。与跨声门型肿瘤（检出率：84.7%，敏感性：71%）相比，声门上型肿瘤显示出更好的结果（检出率：93.7%，敏感性：96%）。放射性示踪剂的表现明显优于蓝色染料，检出率分别为90.8%和81.5%，敏感性分别为88%和77%。SLN定位是一种用于喉SCC分期的可靠技术，特别是对于声门上型肿瘤，其具有较高的检出率和敏感性。与蓝色染料相比，放射性示踪剂表现更优，凸显了它们的临床价值。这些发现支持了SLN活检在喉癌中的可行性和准确性，同时强调了肿瘤位置和定位材料的重要性。
