Sentinel lymph node biopsy in T1/T2 squamous cell carcinomas of the tongue: A prospective study.
Sentinel lymph node biopsy in T1/T2 squamous cell carcinomas of the tongue: A prospective study.
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DOI：
10.3892/ol.2015.3933
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发表时间：
2016-01
期刊：
影响因子：
2.9
通讯作者：
Walter C
中科院分区：
文献类型：
--
作者：
Sagheb K;Sagheb K;Rahimi-Nedjat R;Taylor K;Al-Nawas B;Walter C
常用的分期程序通常无法预测口腔鳞状细胞癌 (SCC) 中是否存在颈部转移 (CM)。由于临床上大量 N0 病例中隐匿性 CM 的发生率较高，因此择期进行颈清扫术 (ND)。前哨淋巴结活检（SNB）是现代恶性肿瘤外科治疗中的一个常见概念。本研究评估了这一概念对于舌头 T1/T2-SCC 的适用性。在一项前瞻性临床研究中，连续招募了 10 名患有舌和 cN0 颈部 T1/T2-SCC 的患者。前哨淋巴结 (SLN) 闪烁扫描后，所有患者均接受使用 γ 探针的 SNB 和随后的 ND。将 SNB 标本与 ND 手术标本的组织病理学评估进行比较。共有 5 名女性和 5 名男性患者（平均年龄 52 岁；女性 62 岁；男性 42 岁）接受治疗，中位随访时间为 33.5 个月（范围 10-40 个月）。所有患者均出现可检测到的前哨淋巴结。 7 例中，SLN 和残余 ND 的 CM 呈阴性。 3 例 SLN 呈阳性，其他颈部淋巴结未出现进一步 CM。此外，1 名患者在 10 个月后在对侧颈部出现额外的 CM，并在 18 个月后出现肺转移，但在初次治疗时没有出现这种情况。 SNB 的概念似乎适用于舌部小 SCC 中 cN0 颈部的治疗。 SNB 在 SCC 治疗中的作用需要通过更多患者数量的前瞻性试验进行进一步研究。
Commonly used staging procedures often cannot predict the absence of cervical metastases (CM) in squamous cell carcinomas (SCCs) of the oral cavity. Due to the high incidence of occult CM in numerous N0 cases in the clinic, an elective neck dissection (ND) is performed. The sentinel lymph node biopsy (SNB) is a common concept in the modern surgical therapy of malignancies. The present study evaluates the applicability of this concept for T1/T2-SCC of the tongue. In a prospective clinical study, 10 consecutive patients with T1/T2-SCC of the tongue and cN0 necks, were enrolled. Following sentinel lymph node (SLN) scintigraphy, all patients underwent SNB with a γ-probe and a subsequent ND. SNB specimens were compared with histopathological assessments of surgical specimens from the ND. A total of 5 female and 5 male patients (mean age, 52 years; women, 62 years; men, 42 years), with a median follow-up time of 33.5 months (range, 10–40 months), were treated. All patients presented with detectable SLNs. In 7 cases, the SLN(s) and the residual ND were negative for CM. In 3 cases, the SLN(s) were positive without further CM in the other neck nodes. Furthermore, 1 patient showed additional CMs after 10 months in the contralateral neck and lung metastasis after 18 months, but none at the time of the initial treatment. The concept of an SNB appears to be applicable to the management of the cN0 neck in small SCC of the tongue. The role of SNB in the management of SCC requires further investigation by prospective trials with larger patient numbers.