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目的:探讨蓝染法在CN0期舌鳞癌前哨淋巴结定位的应用价值。方法:对32例CN0舌鳞癌病例术中应用蓝染法定位前哨淋巴结,采用先翻开颈部皮瓣后再在病灶边缘注射亚甲蓝的方法,观察颈部淋巴结蓝染情况,计数发现淋巴结蓝染的时间及蓝染淋巴结数目,切取蓝染淋巴结送冰冻病理检查,然后完成颈清扫术,观察前哨淋巴结病检结果与术后颈部淋巴结常规病理检查结果的相关性,计算前哨淋巴结对CN0舌癌患者颈部淋巴结转移的预测价值。结果:32例中31例成功定位前哨淋巴结,定位成功率96.88%,从注射染料到出现淋巴结蓝染平均25min,每例平均定位前哨淋巴结1.9个,8例前哨淋巴结病理检查阳性,与术后常规病理检查对照未发现假阴性病例,前哨淋巴结对CN0舌癌颈淋巴结转移的阳性及阴性预测价值均为100%。结论:蓝染法定位CN0期舌鳞癌前哨淋巴结有较高的临床应用价值。
Objective: To investigate the value of blue staining in sentinel lymph node mapping of tongue squamous cell carcinoma of the CN0 stage. Methods: Sentinel lymph nodes were located in 32 cases of tongue squamous cell carcinoma of the tongue with blue dye method. The cervical lymph nodes were observed with blue dye after the neck flaps were opened first and then the methylene blue was injected. Lymph node blue staining time and the number of blue-stained lymph nodes, blue stained lymph node dissection and frozen pathological examination, and then complete neck dissection, observed the results of sentinel lymph node disease and postoperative neck lymph node routine pathological examination results correlation, the calculation of sentinel lymph node pairs Predictive value of neck lymph node metastasis in CN0 tongue cancer patients. Results: Sentinel lymph nodes were successfully located in 31 of 32 cases, with a success rate of 96.88%. From the injected dye to the occurrence of lymph node blue staining for an average of 25 minutes, each case had an average of 1.9 sentinel lymph nodes and 8 cases had positive pathological examination of sentinel lymph node, No false-negative cases were found in pathological examination. The positive and negative predictive value of sentinel lymph node metastasis to CN0 tongue cervical lymph node were 100%. CONCLUSION: The blue dye method has a high clinical value in the localization of sentinel lymph node of tongue squamous cell carcinoma of CN0 in CN0 stage.