Tumour stage is a prognostic indicator for canine malignant head and neck tumours (MHNT). However, consensus is lacking on nodal staging in the absence of clinically apparent nodal disease (cN0 neck). This prospective observational study aims to determine the diagnostic accuracy of radiopharmaceutical and blue dye for sentinel lymph node biopsy (SLNB), to assess the correspondence between sentinel lymph node (SLN) and clinically expected regional lymph node (RLN) and the impact on staging of the procedure in dogs with MHNT and cN0 neck. Twenty-three dogs with MHNT and cN0 neck underwent tumour excision and SLNB guided by preoperative lymphoscintigraphy and intraoperative gamma-probe and blue dye. Diagnostic performances and detection rate were calculated. Correspondence between SLN and RLN, number of nodes excised, histopathological status of the SLN and complications related to the procedure were recorded. The mapping technique identified at least one SLN in 19/23 dogs, with a detection rate of 83%. The SLN did not correspond to the RLN in 52% of dogs. Multiple nodes were removed in 61% of dogs. At histopathology, eight (42%) dogs had SLN+, of which four differed from the RLN. Only minor self-limiting complications occurred in five (22%) dogs. Radiopharmaceutical and blue dye guidance is accurate (sensitivity 88.9%; specificity 100%) for SLNB in dogs with MHNT and cN0 and allowed the extirpation of unpredictable and/or multiple SLN with minimal morbidity. Incorporation of SLNB in the management of MHNT is desirable to correctly stage the cN0 neck, owing the unpredictability of the lymphatic drainage.

中文翻译：

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绘制或不绘制 cN0 颈部：前哨淋巴结活检对犬头颈部肿瘤的影响

肿瘤分期是犬恶性头颈肿瘤（MHNT）的预后指标。然而，在没有临床明显淋巴结疾病（cN0 颈部）的情况下，淋巴结分期缺乏共识。这项前瞻性观察性研究旨在确定放射性药物和蓝色染料对前哨淋巴结活检 (SLNB) 的诊断准确性，评估前哨淋巴结 (SLN) 和临床预期区域淋巴结 (RLN) 之间的对应关系以及对分期的影响。在患有 MHNT 和 cN0 颈部的狗中进行的手术。23 只患有 MHNT 和 cN0 颈部的狗在术前淋巴显像和术中 γ 探针和蓝色染料引导下接受了肿瘤切除和 SLNB。计算诊断性能和检出率。SLN 和 RLN 之间的对应关系，切除的节点数，记录 SLN 的组织病理学状态和与手术相关的并发症。映射技术在 19/23 只狗中至少识别出一个 SLN，检出率为 83%。52% 的狗的 SLN 与 RLN 不相符。61% 的狗切除了多个淋巴结。在组织病理学中，8 只 (42%) 狗患有 SLN+，其中 4 只与 RLN 不同。五只（22%）犬只发生了轻微的自限性并发症。对于 MHNT 和 cN0 犬的 SLNB，放射性药物和蓝色染料指导是准确的（敏感性 88.9%；特异性 100%），并且可以以最小的发病率根除不可预测的和/或多个 SLN。由于淋巴引流的不可预测性，将 SLNB 纳入 MHNT 的管理是正确分期 cN0 颈的理想选择。