舌癌患者非前哨淋巴结转移的预测因素

目的探讨舌鳞癌患者非前哨淋巴结（non-sentinel lymph node,nSLN）转移的预测因素。方法回顾性分析采用单光子发射计算机断层成像术和螺旋CT融合显像技术及蓝染法示踪定位前哨淋巴结（sentinel lymphnode,SLN）活检中存在转移的38例患者,对nSLN进行常规HE染色和CK免疫组化检查,研究nSLN转移与各种临床病理因素的关系。结果当SLN（＋）转移灶最大直径大于2 mm时,nSLN转移率为64.7%（11/17）;当SLN（＋）数目为1时,nSLN转移率为64.3%;当SLN（＋）数目为2时,nSLN转移率为20.0%;当SLN（＋）数目大于等于3时,nSLN转移率为11.1%。nSLN转移率随着肿瘤原发灶浸润深度的增加而增大。结论 nSLN是否转移与SLN（＋）转移灶最大直径、SLN（＋）数目和肿瘤原发灶浸润深度有关。

Predictors of metastasis of nonsentinel lymph nodes in tongue cancer

ObjectiveTo investigate the predictive factors of metastasis of non-sentinel lymph nodes（nSLN） in patients with tongue cancer.MethodsSentinel lymph nodes（SLN） were identified by using a hybrid SPECT/CT System combined with methylene blue.Besides routine HE staining,immunohistochemistry was employed.Thirty-eight cN0 tongue cancer patients had positive SLNs verified by SLN biopsy.The records of all these patients were reviewed to explore the correlation between metastasis in nSLN and clinicopathologic features in these patients.ResultsThe metastasis rate of of nSLN was 64.7%（11/17） in patients with the size of the largest SLN metastasis more than 2 mm.In the patients with a single positive SLN,the metastasis rate of of nSLN was more than that of multiple SLN metastasis（P0.05）.The rate of metastasis in nSLNs became more with the increase of the invasion depth（P0.05）.ConclusionThe metastasis of nSLN in tongue cancer may correlate with the depth of invasion,size of the largest SLN metastasis,and the number of the positive SLNs.