| Summary: | 碩士 === 臺北醫學大學 === 口腔復健醫學研究所 === 92 === Background and Objective: It was still controversy in dealing with the neck lymphatic metastasis during surgical management of oral cancer. How to eradicate the high risk lymph nodes of the neck appropriately also reduce the morbidity is dilemma. Over the past decade since the concept of sentinel lymph nodes first applied to the surgical intervention of melanoma and breast cancer. It had became a routine path in surgical management of above cancers with sentinel lymph nodes biopsy. There were only few articles discussing the sentinel lymph nodes detection in head and neck cancer, nonetheless the oral cancer. In this study we will apply the sentinel lymph nodes concept in the surgical intervention of the oral cancer. Establishing a amenable model of sentinel lymph node detection for oral cancer, and evaluation the value and variability. Methods: There was preoperative clinic N0 stage, oral squamous cell carcinoma collected in this study. Peritumoral injected with unfiltered Tc-99m sulfur colloid, then radiolocalized SLN with lymphoscintigraph and gamma probe. All the cases register the parameters that related to the tumor and individuals. Results: 28 OSCC patients met the criteria and included in this study, 15 in buccal , 7 in tongue, 3 in lip, 2 in gingival and 1 in floor of mouth. 64 SLN in 27 patients was identified by this method, identification rate is 96.4%. 6 patients had positive sentinel nodes, and no fasle negative prediction of SLN in entire study patients. Age, tumor size , morphology , location and time interval. The above parameters have no significant influence to the numbers of sentinel lymph nodes. But the numbers of sentinel lymph nodes of pathologic positive finding cases is significant higher than negative finding cases(p<0.05 by Mann-Whitney U test). Conclusion: Radiolocalization sentinel lymph nodes biopsy by our study model result in acceptable identification and specific rate. The significant higher numbers of sentinel nodes of pathologic positive cases indicated the potential clinical value of sentinel lymph nodes in oral cancer treatment. It will need more clinical trial included to prove that.
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