皮肤黑色素瘤患者的淋巴结及皮下转移超声:一项前瞻性多中心研究结果  

Ultrasound mapping of lymph node and subcutaneous metastases in patients with cutaneous melanoma: Results of a prospective multicenter study

作　　者：Blum A. Schmid-WendtnerM.-H. Mauss-Kiefer V. 党倩丽 

机构地区：[1]Private and Teaching Practice of Dermatology, Seestrasse 3a, DE-78464 Konstanz, Germany Dr

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第3期52-53,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Background: Ultrasound (sonography,B-mode sonography, ultrasonography) examination improves the sensitivity in more than 25% compared to the clinical palpation, especially after surgery on the regional lymph node area. Objective: To evaluate the distribution of metastases during follow-up in the draining lymph node areas from the scar of primary to regional lymph nodes (head and neck, supraclavicular, axilla, infraclavicular, groin) in patients with cutaneous melanoma with or without sentinel lymph node biopsy (SLNB) or former elective or consecutive complete lymph node dissection in case of positive sentinel lymph node (CLND). Methods: Prospective multicenter study of the Departments of Dermatology of the Universities of Homburg/Saar, Tü bingen and Munich (Germany) in which the distribution of lymph node and subcutaneous metastases were mapped from the scar of primary to the lymphatic drainage region in 53 melanoma patients (23women, 30 men; median age: 64 years; median tumor thickness: 1.99 mm) with known primary, visible lymph nodes or subcutaneous metastases proven by ultrasound and histopathology during the follow-up. Results: Especially in the axilla, infraclavicular region and groin the metastases were not limited to the anatomic lymph node regions. In 5 patients (9.4% ) (4 of them were in stage IV) lymph node metastases were not located in the corresponding lymph node area. 32 patients without former SLNB had a time range between melanoma excision and lymph node metastases of 31 months (median), 21 patients with SLNB had 18 months (p < 0.005). In 11 patients with positive SLNB the time range was 17 months, in 10 patients with negative SLNB 21 months (p<0.005); in 32 patientswith CLNDthe time range was 31 months and in 21 patients without CLND 18 months (p< 0.005). In thinner melanomas lymph node metastases occurred later (p< 0.05). Conclusions: After surgery of cutaneous melanom-a, SLNB and CLND the lymphatic drainage can show significant changes which should be considered in clinical and ultrasound follBackground： Ultrasound （sonography, B-mode sonography, ultrasonography） examination improves the sensitivity in more than 25% compared to the clinical palpation, especially after surgery on the regional lymph node area. Objective： To evaluate the distribution of metastases during follow-up in the draining lymph node areas from the scar of primary to regional lymph nodes （head and neck, supraclavicular, axilla, infraclavicular, groin）in patients with cutaneous melanoma with or without sentinel lymph node biopsy （SLNB） or former elective or consecutive complete lymph node dissection in case of positive sentinel lymph node （CLND）. Methods： Prospective multicenter study of the Departments of Dermatology of the Universities of Homburg/Saar,

关 键 词：前瞻性多中心研究 皮肤黑色素瘤 局部淋巴结 皮下转移 超声 患者 前哨淋巴结活检 淋巴结清扫术 外科手术后 淋巴引流区 

分 类 号：R657.1[医药卫生—外科学] R739.5[医药卫生—临床医学]