Gamma-probe-directed lymphatic mapping and sentinel lymphadenectomy in primary cutaneous melanoma
Gamma-probe-directed lymphatic mapping and sentinel lymphadenectomy in primary cutaneous melanoma
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DOI：
10.1159/000063385
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发表时间：
2002-01-01
期刊：
影响因子：
3.4
通讯作者：
Rigo, P
中科院分区：
文献类型：
--
作者：
Belhocine, T;Piérard, GE;Rigo, P
背景资料：放射性示踪剂和蓝染料淋巴映射是一种推荐的联合方法，以指导前哨淋巴结切除术和全区域淋巴结清扫术在选定的皮肤黑色素瘤患者。目的：探讨γ-探针定位淋巴结显像对皮肤黑色素瘤的诊断价值和预后价值。方法：65例I期和11例黑色素瘤患者接受了γ探针导向淋巴管定位。前哨淋巴结进行了研究，常规和免疫组化染色。中位随访时间为11个月。结果：术前和术中前哨淋巴结检测的敏感性分别为100%和98%。腋窝和颈部分别仅1例未检出和1例漏诊同盆转移。11例患者（16.9%）有前哨淋巴结转移，导致辅助治疗。结论：γ-探针定位淋巴结显像对黑色素瘤分期有一定的临床价值。然而，在前哨淋巴结的更具体的识别预期，标准协议仍然建议用于探索腋窝和颈部区域。在某些情况下通过免疫组织化学支持的组织学检查在所有情况下仍然是强制性的。版权所有（C）2002 S. Karger AG，巴塞尔。
Background: Radiotracer and blue-dye lymphatic mapping is a recommended combined method to guide sentinel lymphadenectomy and full regional lymph node dissection in selected patients with cutaneous melanoma. Objective: To evaluate the diagnostic accuracy and the prognostic value of gamma-probe-directed lymphatic mapping in cutaneous melanomas. Methods: Sixty-five stage I and 11 melanoma patients underwent gamma-probe-directed lymphatic mapping. Sentinel lymph nodes were studied by both conventional and immunohistochemical stainings. The median follow-up was 11 months. Results: Sensitivities of preoperative and intraoperative sentinel lymph node detection were 100 and 98%, respectively. Only 1 failure of detection and 1 missed same-basin metastasis were experienced in the axillary and cervical areas, respectively. Eleven patients (16.9%) had sentinel node metastases leading to adjuvant therapy. Conclusion: Gamma-probe-directed lymphatic mapping is useful for staging melanoma. However, in the expectation of a more specific identification of the sentinel lymph node, the standard protocol remains recommended for exploring the axillary and cervical areas. The histological examination supported in some cases by immunohistochemistry remains mandatory in all cases. Copyright (C) 2002 S. Karger AG, Basel.