摘要
目的:探索舌癌哨位淋巴结(sentinel node,SN)检测的理想方法,比较术前核素扫描+术中亚甲蓝示踪法和术中γ探头检测法的应用价值。方法:分别采用术前核素扫描+术中亚甲蓝示踪法(A组)和术中γ探头检测法(B组),对临床N0(clinically N0,cN0)舌癌患者各20例进行SN检测,以颈清扫标本常规病理检查及随访中淋巴结复发与否为评价颈部淋巴结转移状况的金标准,比较2种方法检测SN的有效性;采用SPSS12.0软件包进行χ2检验。结果:A组SN检出率为100%(20/20),隐匿性淋巴结转移的发生率为25%(5/20),SN活检评价颈淋巴结转移状况的准确率为95%(19/20),假阴性1例,阴性预测值均为94%(15/16)。B组SN检出率为95%(19/20),隐匿性颈淋巴结转移率为15%(3/20),SN活检评价颈淋巴结转移状况的准确率和阴性预测值均为84%(16/19),假阴性3例,假阴性率为16%(3/19)。2组SN检出率、阴性预测值无统计学差异,P>0.05。结论:舌癌SN检测方法中,术中γ探头检测法并不优于术前核素扫描+术中亚甲蓝示踪法,后者简便易行,有较高的实用价值。
PURPOSE： This study was designed to screen out an optimal method for detection of sentinel nodes （SN） in tongue cancer patients with clinically NO neck （cNO） and to compare the practical value of preoperative lymphoscintigraphy combined with intraoperative blue dye mapping and intraoperative detection with a γ-probe. METHODS： Preoperative lymphoscintigraphy combined with intraoperative blue dye mapping （group A） and intraoperative detection with γ-probe （group B） were employed to detect sentinel nodes in 20 cases of clinically NO tongue cancer, respectively. Routine pathological examination of the cervical specimen and lymph node metastasis developed during follow-up were set as golden standard to assess the efficacy of SN biopsy with these two methods in evaluating cervical lymph node status. Statistical analysis was performed with SPSS 12.0 software package, Chi-square test being used in ratio comparison. RESULTS： In group A, SNs were detected in all 20 cases and occult cervical lymph node metastases were found in 25% of the cases （5/20）; when SN biopsy was used to evaluate cervical status, the accuracy rate was 95% and the negative predictive value was 94%, with 1 false negative case in this group. In group B, SNs were detected in 19 cases out of 20 cases, with a detection rate of 95%, and occult cervical lymph node metastases were found in 15% of the cases （3/20）; the accuracy rate and negative predictive value of SN biopsy were equally 84%, with false negative in 3 cases. CONCLUSION： Preoperative lymphoscintigraphy combined with intraoperative blue dye mapping is a valuable and convenient method for SN detection in tongue cancer when compared with intraoperative γ probe detection.
出处
《中国口腔颌面外科杂志》
CAS
2007年第5期340-343,共4页
China Journal of Oral and Maxillofacial Surgery
基金
广东省医学科研基金(A2002226)
广东省科技计划项目(粤社科字254-3)~~
关键词
舌癌
哨位淋巴结活检
肿瘤转移
Tongue cancer
Sentinel lymph node biopsy
Tumor metastasis
