Lymphatic drainage patterns of head and neck cutaneous melanoma observed on lymphoscintigraphy and sentinel lymph node biopsy
Lymphatic drainage patterns of head and neck cutaneous melanoma observed on lymphoscintigraphy and sentinel lymph node biopsy
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DOI：
10.1002/hed.20328
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发表时间：
2006-03-01
影响因子：
2.9
通讯作者：
Singer, MI
中科院分区：
文献类型：
--
作者：
Lin, D;Franc, BL;Singer, MI
背景本研究的目的是评估术前淋巴管造影和前哨淋巴结活检（SLNB）观察到的头颈部皮肤黑色素瘤的淋巴引流模式，并确定与临床预测的淋巴引流模式的不一致性。我们对2001年1月至2004年7月期间114例头颈部皮肤黑色素瘤患者进行了回顾性病历分析，这些患者均接受了术前淋巴结造影和SLNB评估。97%的病例至少发现一个前哨淋巴结（SLN）。在术前淋巴结造影中，49例（43%）在临床预测不到的区域发现了SLN。最常见的不一致部位是在标准颈解剖中通常未解剖的区域，如枕叶区，或比先前描述的更远引流的区域，如颈下或颈后。不一致病例的百分比分别为51%、27%和22%。2例术前淋巴结造影未预测到局部复发部位，2例SLNB失败。根据术前淋巴管造影和SLNB的结果，头颈部皮肤黑色素瘤确实具有预期的淋巴引流模式，尽管与先前基于标准颈清扫标本的临床预测引流模式存在不一致。这些“不一致”的部位仍然可以隐藏黑色素瘤，术前淋巴结造影预测的所有部位仍然需要探索。4例复发病例强调了对所有患者进行密切随访的重要性，无论SLNB结果如何。(c)2006 Wiley Periodicals，Inc.
Background. The purpose of this study was to evaluate lymphatic drainage patterns of head and neck cutaneous melanoma observed on preoperative lymphoscintigraphy and sentinel lymph node biopsy (SLNB) and determine discordancy from clinically predicted lymphatic drainage patterns.Methods. We conducted a retrospective chart review of 114 patients with head and neck cutaneous melanomas evaluated with preoperative lymphoscintigraphy and SLNB from January 2001 through July 2004.Results. At least one sentinel lymph node (SLN) was identified in 97% of cases. On preoperative lymphoscintigraphy, an SLN was identified in an area not clinically predicted in 49 cases (43%). The most common sites of discordancy were in areas not typically dissected in standard neck dissections, such as the postauricular region, or in areas of more distant drainage than described previously, such as the inferior or posterior neck. Their percentages of discordant cases were 51%, 27%, and 22%, respectively. The sites of regional recurrence occurred in two cases not predicted on preoperative lymphoscintigraphy and in two cases of failed SLNB.Conclusions. On the basis of preoperative lymphoscintigraphy and the results of SLNB, head and neck cutaneous melanomas do have expected lymphatic drainage patterns despite perceived discordancy with previously clinically predicted drainage patterns that are based on standard neck dissection specimens. These "discordant" sites can still harbor melanoma, and all sites predicted on preoperative lymphoscintigraphy still need to be explored. The four cases of recurrences underscore the importance of close follow-up for all patients regardless of the SLNB result. (c) 2006 Wiley Periodicals, Inc.