[The clinical value of sentinel lymph node detection in laryngeal and hypopharyngeal carcinoma patients with clinically negative neck by methylene blue method and radiolabeled tracer method].
OBJECTIVE
To investigate the clinical value of sentinel lymph node (SLN) detection in laryngeal and hypopharyngeal carcinoma patients with clinically negative neck (cN0) by methylene blue method, radiolabeled tracer method and combination of these two methods.


METHODS
Thirty-three patients with cN0 laryngeal carcinoma and six patients with cN0 hypopharyngeal carcinoma underwent SLN detection using both of methylene blue and radiolabeled tracer method. All these patients were accepted received the injection of radioactive isotope 99 Tc(m)-sulfur colloid (SC) and methylene blue into the carcinoma before surgery, then all these patients underwent intraopertive lymphatic mapping with a handheld gamma-detecting probe and blue-dyed SLN. After the mapping of SLN, selected neck dissections and tumor resections were peformed. The results of SLN detection by radiolabeled tracer, dye and combination of both methods were compared.


RESULTS
The detection rate of SLN by radiolabeled tracer, methylene blue and combined method were 89.7%, 79.5%, 92.3% respectively. The number of detected SLN was significantly different between radiolabeled tracer method and combined method, and also between methylene blue method and combined method. The detection rate of methylene blue and radiolabeled tracer method were significantly different from combined method (P < 0.05). Nine patients were found to have lymph node metastasis by final pathological examination. The accuracy and negative rate of SLN detection of the combined method were 97.2% and 11.1%.


CONCLUSIONS
The combined method using radiolabeled tracer and methylene blue can improve the detection rate and accuracy of sentinel lymph node detection. Furthermore, sentinel lymph node detection can accurately represent the cervical lymph node status in cN0 laryngeal and hypopharyngeal carcinoma.
Xin
X
Zhao
Dajiang
D
Xiao
Jianming
J
Ni
Guochen
G
Zhu
Yuan
Y
Yuan
Ting
T
Xu
Yongsheng
Y
Zhang
D002277:Carcinoma / Q000473:pathology* / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000556:secondary; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology*; D007822:Laryngeal Neoplasms; D007830:Larynx; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008751:Methylene Blue; D037981:Neck Dissection; D000077195:Squamous Cell Carcinoma of Head and Neck; D013194:Staining and Labeling
D008751:Methylene Blue