Avtor/Urednik		Čizmarevič, Bogdan; Žargi, Miha
Naslov		Varovalna bezgavka pri epitelisjkih malignih neoplazmah ustne votline in ustnega dela žrela: prve izkušnje
Prevedeni naslov		Sentinel node in epithelial malignant neoplasms of the oral cavity and oropharynx: first experiences
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 43, št. Suppl 3
Leto izdaje		2004
Obseg		str. 303-7
Jezik		slo
Abstrakt		In patients with squamous cell carcinoma of the oral cavity and oropharynx, management of regional lymph nodes is of the same importance as that of primary tumour. However, removal of these lymph nodes increases the degree of mutilation. This is why it is important to remove only those lymph nodes, which are involved or bear a large probability of involvement with the disease. It is predicted that the largest probability of metastases developing exists in those nodes, which drain the tumour first. If this prediction is correct, there should be no metastases in the regional lymph nodes if there are none in the sentinel node(s). The objective of this prospective study was to prove the validity of the sentinel node concept and its applicability in clinical situations. In nine patients, sentinel nodes were localized preoperatively using dynamic and static scintigraphy, and also intraoperatively using a gamma radiation detector and methylene dye. The removed sentinel node(s) were checked on intraoperative frozen sections, but formal neck dissection depended on previously accepted treatment protocols. The status of the sentinel node(s) was compared with that of other removed neck lymph nodes. The sentinel node(s) and the largest lymph nodes of each neck region were also checked on serial sections (hematoxyllin, eosin, cytokeratin). In all cases where frozen sections of the sentinel lymph node(s) were negative, other removed lymph nodes were also negative. At least one sentinel node was found in all patients.
Izvleček		Pri zdravljenju karcinomov ustne votline in ustnega dela žrela je enako pomembno zdravljenje samega tumorja kot zasevkov v vratnih bezgavkah. Vsaka odstranitev bezgavk vratu pomeni večjo ali manjšo pohabljenost. Zato je pomembno, da odstranimo samo tiste bezgavke, ki vsebujejo karcinomske zasevke, oziroma obstaja velika verjetnost, da so v njih prisotni zasevki. Predvidevamo, da je največja verjetnost zasevkov v tistih bezgavkah, v katere se mezga iz tumorskega področja najprej izliva. Če v teh varovalnih bezgavkah ni karcinomskih zasevkov, jih v drugih bezgavkah vratu ne pričakujemo. V prospektivni študiji smo hoteli dokazati veljavnost koncepta varovalne bezgavke in možnost njene klinične uporabe. Pri devetih bolnikih smo z dinamično in statično scintigrafijo določili mesto varovalne (varovalnih) bezgavke in jih intraoperacijsko poiskali z detektorjem gama sevanja ob istočasni uporabi metilenskega modrila. Bezgavke smo dali na preiskavo z zaledenelim rezom, potem smo nadaljevali predvideno disekcijo vratu. Primerjali smo status varovalne bezgavke z odstranjenimi bezgavkami vratu. Zaradi natančnejše obdelave smo varovalno bezgavko in največje bezgavke posamezne regije pregledali še s serijskimi rezi (hematoksilin-eozin, citokeratin). Pri vseh primerih, kjer v zaledenelem rezu varovalne bezgavke nismo našli karcinomskih zasevkov, jih nismo našli tudi v drugih bezgavkah vratu. V vseh primerih smo uspeli najti varovalno (varovalne) bezgavko.
Deskriptorji		MOUTH NEOPLASMS OROPHARYNGEAL NEOPLASMS CARCINOMA, SQUAMOUS CELL LYMPHATIC METASTASIS NEOPLASM STAGING LYMPH NODE EXCISION METHYLENE BLUE