摘要
目的:评价前哨淋巴结活检(Sentinel lymph node biopsy,SLNB)、淋巴结连续切片及免疫组化检查在口腔鳞癌分期诊断中的价值。方法:cN0期口腔癌患者31例,分别采用蓝染法、SPECT淋巴显像法、术中γ探测法定位前哨淋巴结。淋巴结常规病理检查,同时对常规切片阴性者采用连续切片,分别进行HE染色,和细胞角蛋白AE1/AE3免疫组化检测。评价其对cN0口腔鳞癌颈部淋巴结转移状态的意义。结果:蓝染法、γ探测、SPECT淋巴显像三种方法分别检测出25(80%)、31(100%)、30(96.5%)例,SLN55枚,平均每例1.4(1～3)枚。非SLN1302枚。常规病理检查SLN转移阳性6枚/6例,其中1例伴有非SLN转移阳性。连续切片+常规HE染色,检出1例SLN转移阳性。连续切片+AE3免疫组化染色,检出2例SLN转移阳性。未发现单独的NSLN阳性病例。结论:使用连续病理切片及免疫组化检测可提高SLNB的诊断准确率。
Objective： To assess the significance of sentinel lymph node biopsy （SLNB）, serial sectioning and cytokeratin immunohistochemical staining in the diagnosis and staging of Stage-cN0 oral squamous cell carcinoma （OSCC）. Methods： Paten blue stain of sentinel lymph nodes （SLNs）, 99mTc- dextran SPECT lymphoscintigraphy and intraoperative γ-ray probes were used to examine the SLNs in 31 cases with Stage-cN0 oral cancer. H＆E staining and a cytokeratin AE1/AE3 immunohistochemistry （IHC） assessment, with serial sections, were conducted in addition to a routine pathological examination of lymph nodes. The value of the routine pathological examination of the SLNs, serial sections and IHC determination for cervical lymph node metastasis of Stage-cN0 OSCC was appraised. Results： A total of 45, 55 and 51 SLNs were detected in 25 （80%）, 31 （100%） and 30 （96.5%） of the cases through use of the blue stain, γ-ray probes, and SPECT lymphoscintigraphy, respectively. The average SLNs found in each case of the groups was 1.4 （1 to 3） and there were 1302 non-SLNs. Six positive SLN metastases were detected by routine pathological examination, among which 1 case was found to be an accompanied positive metastasis of non-SLN. One positive SLN metastasis was found after examination of serial sections plus routine H＆E staining and 2 were detected using serial sections plus AE3 immunohistochemical staining methods. No positive non-SLNs were found in the study. Conclusion： In order to make more progress in accurate SLNB diagnosis, serial sections and IHC （AE1/AE3） methods can be used to screen for micrometastases which are difficult to identify by routine pathological sections and H＆E staining alone.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2007年第11期640-643,共4页
Chinese Journal of Clinical Oncology
关键词
口腔鳞癌
前哨淋巴结
微转移
连续病理切片
免疫组化
Oral squamous cell earcinoma Sentinel lymph node Micrometastasis Serial sections Immunohistochemistry
