Sentinel lymph node biopsy for sebaceous cell carcinoma and melanoma of the ocular adnexa
Sentinel lymph node biopsy for sebaceous cell carcinoma and melanoma of the ocular adnexa
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DOI：
10.1001/archotol.133.8.820
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发表时间：
2007-08-01
影响因子：
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通讯作者：
Esmaeli, Bita
中科院分区：
文献类型：
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作者：
Ho, Viet H.;Ross, Merrick I.;Esmaeli, Bita
目的：为一系列接受前哨淋巴结（SLN）活检的眼睑或结膜黑色素瘤或眼睑皮脂腺细胞癌患者提供临床详细信息和长期结局数据。设计：回顾性干预病例系列，回顾临床记录和病理标本。设置：三级综合癌症中心。患者：从2000年12月至2004年10月，在我机构接受眼睑或结膜黑色素瘤或眼睑皮脂腺细胞癌治疗的25名连续患者。手术切除眼睑或结膜肿瘤和前哨淋巴结活检。主要结果测量：局部治疗方式;前哨淋巴结被识别的淋巴池;前哨淋巴结的状态;假阴性率;和局部复发、区域和远处转移的长期模式，以及生存率。结果：7例患者患有结膜黑色素瘤，8例患有眼睑边缘黑色素瘤伴相当大的眼睑结膜成分，10例患有眼睑皮脂腺细胞癌。除1例外，其余均用锝99 m硫胶体作示踪剂。术中，在16例患者中，除了在标测过程中使用蓝色染料外，还使用了锝99 m硫胶体，没有SLN是蓝色的。1例结膜黑色素瘤患者和1例眼睑黑色素瘤患者的SLN组织学阳性。2例眼睑黑色素瘤和2例眼睑皮脂腺细胞癌患者SLN活检阴性，但在随访期间其区域淋巴结复发。总体而言，在随访期间，10例皮脂腺细胞癌患者中有2例（20%）和15例眼睑或结膜黑色素瘤患者中有5例（33%）发生区域淋巴结转移。4例有局部转移的黑色素瘤患者也发生了远处器官转移。两例与皮脂腺细胞癌-1区域转移和我没有开发的远处器官transferation.Conclusions：在这一系列的患者中，组织学阳性的前哨淋巴结的检测可能证明进一步研究前哨淋巴结活检的高风险患者与眼附属器黑色素瘤或眼睑皮脂腺细胞癌。假阴性率高于大多数其他解剖部位前哨淋巴结活检报告的假阴性率。SLN活检阴性的患者仍然需要长期随访，因为他们可能会发生区域或远处转移。
Objective: To provide clinical details and long-term outcome data for a series of patients with eyelid or conjunctival melanoma or eyelid sebaceous cell carcinoma who underwent sentinel lymph node (SLN) biopsy.Design: Retrospective interventional case series with review of clinical records and pathologic specimens.Setting: Tertiary comprehensive cancer center.Patients: Twenty-five consecutive patients treated at I institution for eyelid or conjunctival melanoma or eyelid sebaceous cell carcinoma from December 2000 to October 2004.Interventions: Surgical removal of the eyelid or conjunctival tumor and SLN biopsy.Main Outcome Measures: Local treatment modalities; lymphatic basins in which SLNs were identified; status of SLNs; false-negative rate; and long-term patterns of local recurrence, regional and distant metastasis, and survival.Results: Seven patients had conjunctival melanoma, 8 had eyelid-margin melanoma with a considerable palpebral conjunctival component, and 10 had eyelid sebaceous cell carcinoma. The SLNs were identified in all but I patient by using technetium Tc 99m sulfur colloid as a tracer. Intraoperatively, in 16 patients in whom blue dye was used in addition to technetium Tc 99m sulfur colloid during mapping, no SLN was blue. One patient with conjunctival melanoma and I patient with eyelid melanoma had a histologically positive SLN. Two patients with eyelid melanoma and 2 patients with eyelid sebaceous cell carcinoma had negative findings from SLN biopsy but developed recurrence in their regional lymph nodes during the follow-up period. Overall, during followup, 2 of 10 patients with sebaceous cell carcinoma (20%) and 5 of 15 patients with eyelid or conjunctival melanoma (33%) had regional lymph node metastasis. Four patients with melanoma who had regional metastasis also developed distant organ metastasis. Two patients with sebaceous cell carcinoma-1 with regional metastasis and I without-developed distant organ metastasis.Conclusions: The detection of histologically positive SLNs in this series of patients may justify further study of SLN biopsy for high-risk patients with ocular adnexal melanoma or eyelid sebaceous cell carcinoma. The false-negative rate is higher than that reported for SLN biopsy at most other anatomic sites. Patients with negative findings from SLN biopsy still require careful longterm follow-up because they may develop regional or distant metastasis.