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1、ResearchArticleMolecularStagingofCervicalLymphNodesinSquamousCellCarcinomaoftheHeadandNeck1,22,3341,22,5RobertL.Ferris,LiqiangXi,SivaRaja,JenniferL.Hunt,JunWang,WilliamE.Gooding,262,32,3LoriKelly,JesusChing,JamesD.Luketich,andTonyE.Godfrey1DepartmentsofOtolaryngologyandI
2、mmunology,2UniversityofPittsburghCancerInstitute,Departmentsof3Surgery,4Pathology,and5Biostatistics,UniversityofPittsburgh,Pittsburgh,Pennsylvania;and6Cepheid,Sunnyvale,CaliforniaAbstractoptimalpatientmanagement,currentpreoperativeclinicalmeth-ods,includingnewerradiograp
3、hictechniques,aresuboptimalandClinicalstagingofcervicallymphnodesfrompatientswithmisdiagnosethepresenceorabsenceofcervicalnodalmetastasisinsquamouscellcarcinomaoftheheadandneck(SCCHN)hasmanypatients(3–5).Therefore,duetothelowsensitivityofonly50%accuracycomparedwithdefini
4、tivepathologicdetectingnodalmetastasisandthepoorprognosiswhentheseassessment.Consequently,bothclinicallypositiveandclini-metastasesaremissed,thecurrentmanagementoftheclinicallycallynegativepatientsfrequentlyundergoneckdissectionsnodenegative(cN0)neckcommonlyincludesrouti
5、neelectiveneckthatmaynotbenecessary.Toaddressthispotentialdissection(END)withpathologicexaminationoftheremovedovertreatment,sentinellymphnode(SLN)biopsyiscurrentlylymphnodes.beingevaluatedtoprovidebetterstagingoftheneck.END,orcervicallymphadenectomydoneatthetimeofprimary
6、However,tofullyrealizethepotentialimprovementinpatientsurgeryforSCCHNforacN0neck,isassociatedwithasignificantlycareaffordedbytheSLNprocedure,arapidandaccurateimprovedregionalrecurrence-freesurvivalandlowerincidenceofSLNanalysisisnecessary.Weusedquantitativereversedistant
7、metastases(6–9).Furthermore,whenENDisnotdone,transcription––PCR(QRT-PCR)toscreen40potentialmarkerspatientsoftenpresentlaterwithbulkyneckmetastasesandfortheirabilitytodetectSCCHNmetastasestocervicallymphunresectabledisease.ENDnotonlyprovidesmoreaccuratestaging,nodes.Seven
8、markerswereidentifiedwithgoodcharacter-italsoprovidesobjectivecriteriatodecidewhentogiveadjuvantisticsf
