【作者】 常婷；

【导师】 王晓毅；

【作者基本信息】 四川大学 ， 口腔临床医学， 2003， 硕士

【摘要】 口腔癌易发生颈淋巴结转移，对预后的影响较大。对已有转移的cN+患者行根治性颈清已无异议，但对于颈淋巴结cN0的处理尚有争议，取决于是否对颈淋巴结的病理状态是否有正确的判断。本研究就活性染料示踪前哨淋巴结技术的可行性和准确性作了相关的研究。我们收纳了17例未经治疗的口腔癌患者(cN0 6例，cN1 6例，cN2 3例)，都作了同期根治性颈清，术中用(?)％亚甲兰行癌周注射，并观察蓝染淋巴结。术后将蓝染淋巴结(SLN_)与颈清切除的淋巴结一起送病检，对比SLN和整个颈清标本的组织学状态。我们在15例的12例中找到并定位SLN，其中cN0 6例，cN1 6例，cN2 0例)，检出率为8096，12例中有11例的SLN能准确预测颈淋巴结的组织学状态，准确度为91.7％，其中pN0 7例，pN+ 5例，SLN有转移的有4例，阴性预测率为87.5％(7／8)，对cN1为100％(5／5)，对cN1为66.7％(2／3)。从本研究的结果来看，染料示踪前哨淋巴结技术对cN0口腔癌的颈淋巴结的预测较准确，但样本量太小，无统计学意义，综合其他报道，我们认为活性染料示踪前哨淋巴结技术有一定应用价值，但应同位素示踪法联合使用，提高其准确性，要用于临床还需大量的临床研究和资料。更多还原

【Abstract】 For the patient with cancer of oral cavity ,with a high risk rate of cervical lymph node ,the histopathlogic status of cervical lymph node is an important prognostic factor .Performing radical neck dissection (RND) is routinely with the presence of cN+ neck .while the management of the NO neck is controversial ,that depends on a reliable per-operation neck staging. We examined the feasibility and predictive ability of sentinel lymph node biopsy by dye-guided method. We studied 17 untreated patients with cancer of oral cavity (6cNO, 6 cN1, 2cN2). Each of them underwent the RND, with the injection of 1% Methylene blue intra- operation, and then .after operation ,the SLN sent to histopathologic exam with other lymph node .In 12 of 15 patients ,we located the SLN(80%),(6 of 12 are cNO.another 6 are cNl),In 11of the 12 ,SLN can accurately predicted the pathologic status of cervical lymph node(accuracy is 91.7%). The negative predictive value (NPV) is 87.5%. based on our findings ,and those other authors, we concluded that, sentinel lymph node biopsy by dye-guided method.is efficiency to predict the neck status of cNO patient with cancer of oral cavity, but the number of the patient in our serial is so small that the clinical experience with the technique is limited. The sentinel lymph node biopsy by dye-guided method need further clinical trail.更多还原