皮肤恶性黑素瘤的前哨淋巴结活检技术  

Sentinel lymph node biopsy in cutaneous melanoma

作　　者：徐宇[1] 朱蕙燕[1] 吴江宏[1] 龙子雯[1] 刘晓文[1] 郑洪途[1] 王亚农[1] 

机构地区：[1]复旦大学附属肿瘤医院腹部外科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《肿瘤》2011年第1期64-68,共5页Tumor

摘　　要：目的:评估前哨淋巴结活检(sentinel lymph node biopsy,SLNB)应用于皮肤恶性黑素瘤诊断和治疗中的临床价值。方法:对18例临床评估无区域淋巴结转移的皮肤恶性黑素瘤患者,应用淋巴核素显像以及术中核素扫描等方法定位前哨淋巴结(sentinel lymph node,SLN);切除SLN后进行快速冰冻和常规石蜡切片病理检查,若SLN为阳性,则加行相应区域淋巴结清扫。结果:18例患者中共检出SLN34枚,其中阳性7枚(20.6%)。5例SLN阳性患者加行区域淋巴结清扫,包括3例腹股沟清扫、1例腋窝清扫和1例颈部清扫;除SLN以外,共清扫淋巴结84枚,其中阳性39枚(46.4%)。结论:SLNB有助于诊断皮肤恶性黑素瘤的淋巴转移,为实施区域淋巴清扫提供重要的临床依据。Objective： To determine the potential value of sentinel lymph node biopsy （SLNB） for diagnosis and treantment of patients with cutaneous melanoma. Methods： Eighteen patients who underwent SLNB were clinically diagnosed as having cutaneous melanoma. Preoperative lymphoscintigraphy and intraoperative γ detector probe were used to identify the sentinel lymph node （SLN）, and then the intraoperative frozen section and the conventional paraffin section were applied for pathological examination. The local lymph node dissection was performed in case of positive SLN. Results： A total of thirty-four SLNs were identified. Of these, seven （7/34, 20.6%） were detected positive. In five patients with positive SLNs, local lymphadenectomies were performed, including three with inguinal lymphadenectomy, one with axillary lymphadenectomy and one with cervical lymphadenectomy. Except for SLNs, 84 lymph nodes were identified and 39 of them （39/84, 46.4%） were positive. Conclusion： SLNB can provide reliable clinical evidence for diagnosing local lymph nodal metastasis and performing lymphadenectomy for cutaneous melanoma, while the conventional clinical assessments can not accurately determine the nodal status.

关 键 词：黑素瘤 皮肤肿瘤 前哨淋巴结活组织检查 核素 

分 类 号：R739.5[医药卫生—肿瘤]