中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2009年
7期
532-535
,共4页
程艳%王斌全%李思进%温树信%张春明%张万春%武志芳%吴力翔
程豔%王斌全%李思進%溫樹信%張春明%張萬春%武誌芳%吳力翔
정염%왕빈전%리사진%온수신%장춘명%장만춘%무지방%오력상
喉肿瘤%前哨淋巴结活组织检查%SPECT-CT%亚甲蓝
喉腫瘤%前哨淋巴結活組織檢查%SPECT-CT%亞甲藍
후종류%전초림파결활조직검사%SPECT-CT%아갑람
Layngeal neoplasms%Sentinel lymph node,biopsy%SPECT-CT%Methylene blue
目的 应用核素法、染料法以及二者联合法检测cN0喉癌患者前哨淋巴结(SLN),并评价SLN对颈部淋巴结转移状况的预测价值.方法 41例cN0喉癌患者采用核素法、染料法和联合法示踪SLN.核素法为手术前于喉镜引导下在肿瘤周围注射99TCm-硫胶体(SC)进行SLN显像,手术中用γ探针探测放射性"热点";染料法为手术中注射亚甲蓝,示踪蓝染的SIN;联合法为将核素法和染料法联合应用的方法.结果 核素法、染料法和联合法对SLN的检出率分别为87.8%、70.7%和92.7%(P<0.01);核素法与联合法、染料法与联合法检出SIN数目的 差异有统计学意义(P<0.05,P<0.01),核素法与染料法检出SLN数目的 差异无统计学意义(P>0.05).病理结果示,有9例患者淋巴结转移,占22.0%.联合法检测SLN的灵敏度、准确度和阴性预测值分别为88.9%、97.4%和96.7%.结论 联合应用核素法和染料法可提高SEN检出的准确性,SLN的病理结果可以准确预测cN0喉癌患者颈部淋巴结的病理状态.
目的 應用覈素法、染料法以及二者聯閤法檢測cN0喉癌患者前哨淋巴結(SLN),併評價SLN對頸部淋巴結轉移狀況的預測價值.方法 41例cN0喉癌患者採用覈素法、染料法和聯閤法示蹤SLN.覈素法為手術前于喉鏡引導下在腫瘤週圍註射99TCm-硫膠體(SC)進行SLN顯像,手術中用γ探針探測放射性"熱點";染料法為手術中註射亞甲藍,示蹤藍染的SIN;聯閤法為將覈素法和染料法聯閤應用的方法.結果 覈素法、染料法和聯閤法對SLN的檢齣率分彆為87.8%、70.7%和92.7%(P<0.01);覈素法與聯閤法、染料法與聯閤法檢齣SIN數目的 差異有統計學意義(P<0.05,P<0.01),覈素法與染料法檢齣SLN數目的 差異無統計學意義(P>0.05).病理結果示,有9例患者淋巴結轉移,佔22.0%.聯閤法檢測SLN的靈敏度、準確度和陰性預測值分彆為88.9%、97.4%和96.7%.結論 聯閤應用覈素法和染料法可提高SEN檢齣的準確性,SLN的病理結果可以準確預測cN0喉癌患者頸部淋巴結的病理狀態.
목적 응용핵소법、염료법이급이자연합법검측cN0후암환자전초림파결(SLN),병평개SLN대경부림파결전이상황적예측개치.방법 41례cN0후암환자채용핵소법、염료법화연합법시종SLN.핵소법위수술전우후경인도하재종류주위주사99TCm-류효체(SC)진행SLN현상,수술중용γ탐침탐측방사성"열점";염료법위수술중주사아갑람,시종람염적SIN;연합법위장핵소법화염료법연합응용적방법.결과 핵소법、염료법화연합법대SLN적검출솔분별위87.8%、70.7%화92.7%(P<0.01);핵소법여연합법、염료법여연합법검출SIN수목적 차이유통계학의의(P<0.05,P<0.01),핵소법여염료법검출SLN수목적 차이무통계학의의(P>0.05).병리결과시,유9례환자림파결전이,점22.0%.연합법검측SLN적령민도、준학도화음성예측치분별위88.9%、97.4%화96.7%.결론 연합응용핵소법화염료법가제고SEN검출적준학성,SLN적병리결과가이준학예측cN0후암환자경부림파결적병리상태.
Objective The purpose of this study was to investigate the clinical value of radiolabeled tracer method, methylene blue method and combination of these two methods in detection of sentinel lymph node (SLN), and to evaluate the accuracy of SEN in predicting the cervical lymph nodes status in laryngeal carcinoma patients with clinically negative neck lymph nodes (cN0). Methods Forty-one patients with cN0 laryngeal neoplasms underwent SEN detection using both of radiolabeled tracer and methylene blue. SIN imaging was performed with laryngoacope-guided injection of radioactive isotope 99Tcm-sulfur colloid (SC) into the laryngeal carcinoma before surgery, then all these patients underwent intraoperative lymphatic mapping with a handheld gamma-detecting probe. After mapping of SEN, methylene blue was subsequently injected at the same spots around the tumor in order to identify SLN during surgery. The results of SLN detection by isotope tracer, dye and combination of both methods were compared. Results The SLN detection rates by radiolabeled tracer, methylene blue and combined method were 87.8%, 70.7% and 92.7%, respectively (P<0.01). The number of detected SEN was significantly different between radiolabeled tracer method and combined method (P < 0. 05), and also between blue dye method and combined method (P <0. 01). However, no statistically significant difference was found between methylene blue method and radiolabeled tracer method (P > 0.05). Nine patients were found to have lymph node metastasis by final pathological examination. The sensitivity, accuracy and negative predictive values of SLN detection by the combined method using radiolabeled tracer and methylene blue were 88.9%, 97.4% and 96.7%, respectively. Conclusion The combined method using radiolabeled tracer and methylene blue can improve the accuracy of sentinel lymph node detection. Furthermore, sentinel lymph node detection can accurately predict the cervical lymph node status in cN0 laryngeal carcinoma.