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首页> 外文期刊>BJU international >Evaluation of dynamic lymphoscintigraphy and sentinel lymph-node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma.
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Evaluation of dynamic lymphoscintigraphy and sentinel lymph-node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma.

机译：评价动态淋巴活检和前哨淋巴结活检以检测阴茎鳞状细胞癌患者的隐匿性转移。

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OBJECTIVE To evaluate the introduction of dynamic lymphoscintigraphy and sentinel lymph-node (SLN) biopsy (used to detect occult lymph node metastases in patients with penile cancer and clinically impalpable inguinal lymph nodes at presentation) at a UK tertiary referral centre for penile cancer. PATIENTS AND METHODS In all, 75 patients with penile squamous cell carcinoma of stage T1, grade >/= 2, and unilateral or bilateral impalpable groin nodes, were prospectively enrolled over a 2-year period. Patients underwent lymphoscintigraphy with (99m)technetium-labelled nanocolloid which was injected intradermally around the tumour or into the distal penile shaft skin. Four hours later, the SLN(s) were identified during surgery using a hand-held gamma-probe and intradermal injections with blue dye. Completion lymph node dissection was subsequently used in patients with tumour-positive SLNs. RESULTS In all, 255 SLNs were removed from 143 groins; all excised nodes had taken up the radioactive marker, and the blue dye was evident in 87%. Eighteen of 75 (24%) patients and 21 of 143 groins (15%) had a tumour-positive SLN. All but one patient went on to completion lymph node dissection. Three of these 18 (17%) had further disease in other than SLNs. Six of 143 (4%) groins developed minor complications. One false-negative result was reported at a median (range) follow-up of 11 (2-24) months. CONCLUSION This technique is feasible for managing penile cancer in a UK tertiary referral centre. The initial results suggest that it can accurately identify the SLN(s), which can then be removed for pathological review with minimal morbidity.
机译：目的在英国第三级阴茎癌转诊中心评估动态淋巴活检和前哨淋巴结（SLN）活检（用于检测阴茎癌和临床上无痛性腹股沟淋巴结转移的患者）的活检方法。患者与方法在两年期间内，总共入选了75例T1级≥/ = 2的阴茎鳞状细胞癌，以及单侧或双侧不可触及的腹股沟淋巴结。患者接受了（99m）tech标记的纳米胶体的淋巴造影术，该胶体被注射到肿瘤周围或阴茎干远端皮肤内。四小时后，在手术过程中使用手持式伽马探针和蓝色染料进行皮内注射鉴定出SLN。随后在肿瘤阳性SLN患者中使用完整的淋巴结清扫术。结果总共从143个腹股沟中移除了255个SLN;所有切除的结节都吸收了放射性标记，蓝色染料的阳性率高达87％。 75名患者中的18名（24％）和143个腹股沟中的21名（15％）患有肿瘤阳性的SLN。除一名患者外，所有患者均继续完成淋巴结清扫术。在这18位患者中，有3位（17％）除了SLN外还患有其他疾病。 143个腹股沟中有6个（4％）发生了轻微并发症。在中位（范围）随访11（2-24）个月时报告了一个假阴性结果。结论该技术对于在英国三级转诊中心治疗阴茎癌是可行的。初步结果表明，它可以准确识别SLN，然后可以将其移除，以最低的发病率进行病理检查。

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