纳米炭示踪肢端及皮肤恶性黑色素瘤前哨淋巴结活检的临床意义  

The Clinical Significance of Limb-nano-carbon and Sentinel Lymph Node( SLN) Biopsy in Cutaneous Malignant Melanoma

作　　者：游小龙 陈雯[1] 柴国生 胡崇萌 YOU Xiaolong;CHEN Wen;CHAI Guosheng(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]江西省肿瘤医院,330029

出　　处：《实用癌症杂志》2018年第11期1876-1877,1889,共3页The Practical Journal of Cancer

摘　　要：目的探讨纳米炭示踪肢端及皮肤恶性黑色素瘤前哨淋巴结(SLN)活检的临床意义。方法收集肢端及皮肤恶性黑色素瘤手术治疗的患者,Breslow厚度均> 1 mm或原发灶术后病理T分期T2~4。采用区域影像学提示无淋巴结肿大和有淋巴结肿大,分为前哨淋巴结冰冻活检组和直接清扫组。纳米炭淋巴示踪组患者在距肿瘤周缘0. 5~1. 0cm处选择3、6、9或12点处缓慢注射纳米碳混悬液。比较两组术后标本中淋巴结清扫数及转移度,分析前哨淋巴示踪与区域淋巴结清扫重要意义。结果共收集35例患者,其中前哨淋巴示踪冰冻活检组19例,3例前哨淋巴结阳性,阳性率15. 8%;直接清扫组16例,14例有区域淋巴结转移,2例反应性增生。结论前哨淋巴结活检技术在肢端及皮肤黑色素瘤中是一种可靠的技术,具有重要的临床意义。Objective To explore the clinical significance of limb-nano-carbon tracer and cutaneous malignant melanoma sentinel lymph node(SLN)biopsy.Methods Selected limb and skin surgical operation for malignant melanoma patients,the thickness of the Breslow>1mm or primary lesion postoperative pathological T stage T2-4 regional lymph node accepted B ultrasound examination,enhanced CT,MRI and exception of the local lymph node enlargement was nano-carbon tracer sentinel lymph node biopsy.Regional imaging was used to suggest that whether there was lymph node enlargement and divided into sentinel lymph node frozen biopsy group and direct cleaning group.In the nano-carbon lymphatic tracer group and around the tumor 0.5~1.0 cm,choose 3,6,9 or 12 clock direction to slowly inject the nano-carbon suspension.comparing the lymph node dissection and metastasis between the 2 groups,and analyze the significance of sentinel lymphatic tracer and regional lymph node dissection.Results 35 patients were collected,among which 19 were sentinel lymph frozen biopsy tracers,3 were sentinel lymph node positive,and the positive rate was 15.8%.There were 16 cases in the direct cleaning group,14 had regional lymph node metastasis,and 2 were reactive hyperplasia.Conclusion Sentinel lymph node(SLN)biopsy is a reliable technique in limbs and cutaneous melanoma,which has important clinical significance.

关 键 词：端及皮肤恶性黑色素瘤 前哨淋巴结活检 纳米碳 淋巴结示踪 

分 类 号：R739.63[医药卫生—肿瘤]