目的:运用染料法、核素法以及两者联合法检测cN0期喉癌及下咽癌前哨淋巴结(SLN),评价SLN对颈部淋巴结转移状况的预测价值。方法:33例喉癌和6例下咽癌患者采用染料法、核素法及两者联合法检测SLN。染料法为术中全身麻醉下注射亚甲蓝,检测蓝染的SLN;核素法为术前注射99m锝-硫胶体,术中用γ-探针探测高能核素浓集的淋巴结;联合法为染料法、核素法联合运用。SLN全部切除后行相应的喉切除加选择性颈淋巴结清扫术,所有淋巴结送常规病理检查。结果:染料法、核素法以及联合法对SLN的检出率分别为79.5%、89.7%、92.3%,核素法、染料法与联合法SLN检出率比较,均差异有统计学意义(均P<0.05)。病理结果显示39例患者中,术后常规病理切片发现转移9例(23.1%)。联合法检出SLN的灵敏度、准确率、假阴性率分别为88.9%、97.2%、11.1%。结论:联合运用染料法和核素法提高了SLN的检出率和正确率,SLN的病理结果比较准确地反映出cN0喉癌和下咽癌患者颈部淋巴结的病理状态,该技术具有良好的临床应用前景。 OBJECTIVE: To evaluate the predictive value of SLN on cervical lymph node metastasis by using the dye method, the radionuclide method and the combination of the two methods to detect cN0 laryngeal cancer and sentinel lymph node (SLN) of hypopharyngeal cancer. Methods: Thirty-three patients with laryngeal carcinoma and 6 patients with hypopharyngeal carcinoma were examined for SLN by the dye method, the radionuclide method and the combination of the two methods. Dye method for the injection of methylene blue under general anesthesia during surgery to detect the blue dye SLN; nuclide injection of 99m technetium-sulfur colloid before surgery, intraoperative use of γ-probe detection of high energy nuclide-rich lymph nodes; For the dye method, nuclide method combined use. All resection of SLN after the corresponding laryngectomy plus selective cervical lymph node dissection, all lymph nodes to send routine pathological examination. Results: The detection rates of SLN by dye method, nuclide method and combined method were 79.5%, 89.7%, 92.3%, respectively. There were significant differences between the two methods (nuclide method, dye method and SLN method) All P <0.05). Pathological findings showed that in 39 patients, 9 cases (23.1%) were found to have metastasized by routine pathological examination. The sensitivity, accuracy and false negative rate of SLN detected by the combined method were 88.9%, 97.2% and 11.1% respectively. Conclusion: The combination of dye method and nuclide method can improve the detection rate and correct rate of SLN. The pathological results of SLN accurately reflect the pathological state of cervical lymph nodes in cN0 laryngeal and hypopharyngeal cancer patients. The technique has good Clinical application prospects.