lymphatic mapping and sentinel node analysis.docVIP

Lymphatic Mapping and Sentinel Node Analysis nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; 作者：Current Concepts and Applications 【关键词】nbsp; Steven,L.,Chen,,MD,,MBA,,Douglas,M.,Iddings,,DO,,Randall,P.,Scheri,,MD,and,Anton,J.,Bilchik,,MD,,PhD,,FACS Steven L. Chen, MD, MBA, Douglas M. Iddings, DO, Randall P. Scheri, MD and Anton J. Bilchik, MD, PhD, FACS Dr. Chen is Fellow in Surgical Oncology, John Wayne Cancer Institute, Santa Monica, CA. Dr. Iddings is Fellow in Surgical Oncology, John Wayne Cancer Institute, Santa Monica, CA. Dr. Scheri is Fellow in Surgical Oncology, John Wayne Cancer Institute, Santa Monica, CA. Dr. Bilchik is Director, Gastrointestinal Program; Director of Gastrointestinal Surgical Oncology, John Wayne Cancer Institute, Santa Monica, CA. nbsp; nbsp;nbsp;nbsp; ABSTRACT Since the introduction of sentinel node biopsy in 1990 as a minimally invasive surgical technique for the diagnosis of melanoma lymphatic metastases, the number of applications has expanded. We review applications and the current status of sentinel node biopsy in melanoma, breast, colon, gastric, esophageal, head and neck, thyroid, and lung cancer. Variations on techniques specific to each organ are explained, and the current role of sentinel node biopsy in diagnosis and treatment is discussed. nbsp;nbsp;nbsp; INTRODUCTION The sentinel node is commonly defined as the initial lymph node to which the primary tumor drains. The reintroduction of this concept in 1990,1 coupled with the ability to detect sentinel nodes, has radically changed the method of staging melanoma and breast cancer. The concept of sentinel lymph node (SLN) mapping assumes an orderly progression of metastatic disease from the primary tumor to the lymphatic system. It postulates that tumors drain directly to a limited number of lymph nodes in a specific lymphatic drainage basin. Use of tracers allows identification of these tumor-draining lymph nodes for further e