Study for sentinel lymph node detection by nuclear medical method in oral cancer

背景和目的：前哨淋巴结导航有望减少肿瘤手术中淋巴结清扫的需要。我们研究前哨淋巴结的概念是否适用于口腔癌。患者与方法：研究对象为2002年4月至2003年7月间行口腔鳞状细胞癌一期切除及颈部清扫术的患者7例。术前在原发病灶周围注射99mTc标记植酸盐作为示踪剂。术前淋巴显像及术中伽玛探针检查前哨淋巴结。解剖淋巴结行组织病理学和核放射学检查。结果：所有患者均在下颌下区发现前哨淋巴结，3例在颈椎区发现附加淋巴结。3例发现转移灶，其中1例前哨淋巴结下游有多发转移灶。另一例在解剖区外进一步转移。结论：前哨淋巴结的检测符合上述标准，前哨淋巴结概念在口腔癌的应用是合理的。

Background and Aims : Sentinel lymph node navigation is expected to reduce the need for lymph node dissection in cancer surgery. We studied whether the sentinel lymph node concept is applicable to oral cancer.Patients and methods : Subjects were 7 patients with oral squamous cell carcinoma undergoing primary resection and neck dissection between April 2002 and July 2003. They were injected with 99mTc labeled phytate surrounding primary lesion for tracers preoperatively. Preoperative lymphoscintigraphy and intraoperative identification by gamma probe were done to detect sentinel lymph nodes. Dissected lymph nodes were examined histopathologically and nuclear-radiologically.Results : Sentinel lymph nodes were recognized at the submandibular region in all patients, and additional nodes at the cervical region in 3 cases. Metastatases were identified in 3 cases, one of whom had multiple metastases downstream from the sentinel lymph node. Another had further metastasis outside the dissection area.Conclusion : Sentinel lymph nodes are detected as described above and the sentinel lymph node concept is reasonable for oral cancer application.