Sentinel node biopsy for high-risk nonmelanoma cutaneous malignancy.
Sentinel node biopsy for high-risk nonmelanoma cutaneous malignancy.
复制标题
高危非黑色素瘤皮肤恶性肿瘤的前哨淋巴结活检。
作者：
J. Wagner;David Z Evdokimow;E. Weisberger;D. Moore;T. Chuang;S. Wenck;J. J. Coleman
目的
评价前哨淋巴结分期检测高危皮肤非黑色素瘤恶性肿瘤隐匿性区域淋巴结转移的可行性。
设计
连续性临床病例系列。
设置
转诊大学医学中心。
患者
一个连续样本的患者与各种高风险的非黑色素瘤皮肤恶性肿瘤没有证据的区域淋巴结转移。
干预
前哨淋巴结活检采用术前淋巴结造影、蓝色染料和术中放射定位。
主要观察指标
灵敏度，通过比较活检标本评价结果与完成淋巴结切除术和/或临床随访结果确定。
结果
24例患者接受前哨淋巴结活检，对淋巴结造影确定的29个淋巴结盆进行分期。初步诊断为鳞状细胞癌（n = 17）、默克尔细胞癌（n = 5）和腺癌（n = 2）。7例患者（29%）有肿瘤阳性前哨淋巴结。12例患者进行前哨淋巴结活检，然后进行完全淋巴结切除术，12例患者仅进行前哨淋巴结活检。8例患者中观察到肿瘤阳性淋巴结，其中7例还具有阳性前哨淋巴结。1例复发性头皮鳞状细胞癌患者出现1个假阳性结果（1/8 [12%]）。在中位随访10个月时，未观察到前哨淋巴结阴性盆的复发。与所有信息相比，前哨淋巴结分期的敏感性为88%，阴性预测值为0.94。
结论
前哨淋巴结活检是一种微创分期程序，可用于确定非黑色素瘤皮肤恶性肿瘤患者的隐匿性区域淋巴结疾病。进一步的研究，以验证这些发现，并制定正式的指导方针。
OBJECTIVE
To evaluate the feasibility of sentinel node staging for detection of occult regional lymph node metastasis in high-risk cutaneous nonmelanoma malignancies.
DESIGN
Consecutive clinical case series.
SETTING
Referral university medical center.
PATIENTS
A consecutive sample of patients with a variety of high-risk nonmelanoma cutaneous malignancies without evidence of regional lymph node metastases.
INTERVENTION
Sentinel node biopsies were performed using preoperative lymphoscintigraphy, blue dye, and intraoperative radiolocalization.
MAIN OUTCOME MEASURE
Sensitivity, determined by comparing the results of biopsy specimen evaluation with those of completion lymphadenectomy and/or clinical follow-up.
RESULTS
Twenty-four patients underwent sentinel node biopsy for the staging of 29 nodal basins identified by lymphoscintigraphy. Primary diagnoses were squamous cell carcinoma (n = 17), Merkel cell carcinoma (n = 5), and adenocarcinoma (n = 2). Seven patients (29%) had a tumor-positive sentinel node. Sentinel node biopsy followed by complete lymphadenectomy was performed in 12 patients and sentinel node biopsy alone in 12 patients. Tumor-positive lymph nodes were noted in 8 patients, 7 of whom also had positive sentinel nodes. There was 1 false-positive result (1/8 [12%]), in a patient with recurrent squamous cell carcinoma of the scalp. At a median follow-up of 10 months, no recurrences in a sentinel node-negative basin have been noted. Compared with all information, the sensitivity of sentinel node staging was 88% and the negative predictive value was 0.94.
CONCLUSIONS
Sentinel node biopsy is a minimally invasive staging procedure useful in identifying occult regional lymph node disease in selected patients with nonmelanoma cutaneous malignancies. Further studies to verify these findings and develop formal guidelines are indicated.
影响因子：
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作者：
D. Morton;Wenger Dr;J. Wong;J. Economou;L. Cagle;Storm Fk;L. Foshag;A. Cochran
通讯作者：
D. Morton;Wenger Dr;J. Wong;J. Economou;L. Cagle;Storm Fk;L. Foshag;A. Cochran
接受前哨淋巴结活检的黑色素瘤患者淋巴结盆地氟脱氧葡萄糖-正电子发射断层扫描成像的前瞻性研究。
DOI：
10.1200/jco.1999.17.5.1508
发表时间：
1999
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
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作者：
Wagner,JD;Schauwecker,D;Davidson,D;Coleman3rd,JJ;Saxman,S;Hutchins,G;Love,C;Hayes,JT
通讯作者：
Hayes,JT