皮肤恶性黑素瘤的前哨淋巴结活检技术.PDFVIP

64 肿瘤2011年1月第31卷第1期 Tumor Vol. 31, J anuary, 2011 DOI:10.3781/j .issn.1000-7431.2011.01.013 Clinical Research ·临床研究 皮肤恶性黑素瘤的前哨淋巴结活检技术 徐 宇，朱蕙燕，吴江宏，龙子雯，刘晓文，郑洪途，王亚农 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 [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SLN 34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。 [关键词]  黑素瘤；皮肤肿瘤；前哨淋巴结活组织检查；核素 [中图分类号]  R739.5           [文献标志码]  A               [文章编号]  1000-743 1 （20 11）0 1-0064-05 Sentinel lymph node biopsy in cutaneous melanoma XU Yu, ZHU Hui-yan, W U J iang-hong, LONG Zi-wen, LIU X iao-wen, ZHENG Hong-tu, WANG Ya-nong Department of A bdominal Surgery , Shanghai Cancer Center, Department of Oncology , Shanghai Medical College, Fudan University , Shanghai 200032, China [A BST RA CT ] Obj ectiv e : T o dete rmine t he pote nt ia l v a lue of se nt ine l ly mph node bio psy (S LNB) fo r d iag nosis a nd t rea nt me nt of pat ie nt s w it h cuta neous me la no ma . Methods : Eig htee n pat ie nt s w ho unde rw e nt S LNB w e re c linica lly d iag no sed a s hav ing c uta neo us me la no ma . Preo pe rat iv e ly mphoscintigraphy and intraoperative γdetector probe were used to identify the sentinel ly mph node (SLN), and then the intraoperative frozen section and the conventional paraffin section were applied for pathological examination. T he local ly mph 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 w ith positive SLNs, local ly mphadenectomies were performed, including three w ith inguinal ly mph