cN0喉癌前哨淋巴结的临床研究.docVIP

cN0喉癌前哨淋巴结的临床研究 作者：韩靓，蒋斌，顾云飞，陈卫贤，1黄剑飞 作者单位：南通大学附属肿瘤医院头颈外科，通州226361 【摘要】 目的：确定cN0喉癌前哨淋巴结术中标识的可行性及其预测cN0喉癌淋巴结转移情况的准确性。方法：使用亚甲蓝对未经治疗的cN0期喉癌32例行前哨淋巴结术中标识，并作快速冰冻病理与手术后常规石蜡切片病理对照，观察冰冻病理与常规病理淋巴结转移的相关性。结果：喉癌32例中30例(93.8%)成功检测出前哨淋巴结49枚，平均每例1.7个。前哨淋巴结冰冻病理阳性11例，转移率为36.7%，常规颈淋巴结病理均证实有转移；非前哨淋巴结转移4例。隐匿转移率13.3%。组间比较显示（P＜0.05），SLN检出在Ⅱ区LN最多。结论：亚甲蓝示踪法能有效地对cN0喉癌进行SLN定位，并准确的评价颈部淋巴结转移状况，且具有可操作性和实用性，可为减少手术创伤、提高生存质量提供依据。 【关键词】 喉癌；前哨淋巴结；淋巴转移；亚甲蓝染色 Clinical study of sentinel lymph node in cN0 laryngeal carcinoma HAN Liang，JIANG Bin，GU Yunfei，et al （Department of Cephalocevical Surgery, Affiliated Cancer Hospital of Nantong Universiry，Tongzhou 226361） [Abstract] Objective：To investigate a method to detect the sentinel lymph node in cN0 laryngeal carcinoma and its predictive value for cervical metastasia of carcinoma. Methods：Intraoperative methylene blue dye mapping was performed in 32 untreated cases of cN0 laryngeal carcinoma. Sentinel lymph node The frozen sections of SLN were compared with the routine patholonical sections of the cervical lymph nodes. The metastatic relation between the SLN and the cervical nodes as well as SN as predictive value to the cervical nodes metastasis were analyzed. Results：SLN was successfully revealed in 30 of these 32 patients, averaning 1.7 nodes per patient. Eleven of these SLNs were positive both routine patholonical sections and the frozen sections. The cervical lymph node metastasis was 36.7% .Four had lymph node metastasis in addition to the SN. The cervical lymph node negetive metastasis was 13.3% Differences between the groups revealed（P＜0.05），SLN which detected in District II is themost Conclusion Methylene blue dyemapping can be used to assess the cervical lymph node status of cN0 laryngeal carcinoma accurately. The method is efficient and practicable, it is possible for patients to decrease surgical trauma and to elevate living quality. [Key words] Laryngeal neoplasm; Senti