Objective: By performing sentinel lymph node (SLN) biopsy, its detecting and predictive value to the cervical metastasis in the head and neck cancer patients was studied.
Methods: Intraoperative SLN biopsy was done in 51 untreated head and neck cancer patients who all had no metastasis before operation. The lesions were: laryngeal cancer 23, pharyngeal cancer 6, thyroid cancer 20 and cancer of the tongue 2. Fifteen minutes before taking the SLN, local 0.2 to 0.5 ml 2% isosulfan blue dye was submucously injected 0.5 cm away from the upper, lower, right and left margin of the primary tumor. The frozen sections of SLN were compared with the routine pathological sections of the cervical lymph nodes. The metastatic relation between the SLN and the cervical nodes as well as SLN's predictive value to the cervical nodes metastasis were analyzed.
Results: SLN was successfully revealed in 48 (94%) of these 51 patients, averaging 2.5 nodes per patient. They were: laryngeal cancer 22, pharyngeal cancer 6, thyroid cancer 18 and lingual cancer 1. Eleven of these SLNs were positive, among whom two had lymph node metastasis in addition to the SLN. Two others were false negative. The positive predictive value of SLNs to the cervical lymph node metastasis was 85%.
Conclusion: The predictive value of sentinel lymph node to the cervical metastasis is important in head and neck cancer patients.