Evaluation of staging workup in malignant melanoma.
Evaluation of staging workup in malignant melanoma.
复制标题
恶性黑色素瘤分期检查的评估。
作者：
T. Khansur;Jane A. Sanders;Suman Das
为了评估分期检查在原发性和复发性恶性黑色素瘤中的作用，我们回顾了115名原发性黑色素瘤患者和28名复发性疾病患者的结果，这些患者接受了胸部X光片、放射性核素骨和肝脏扫描以及放射性核素脑部扫描或脑部计算机断层扫描。在42例患者中获得了小肠随访的上消化道系列。143例胸部X线片中有9例，137例肝脾扫描中有7例，141例骨扫描中有3例，85例脑扫描中有2例，43例脑计算机断层扫描中有2例，42例上消化道系列中有2例记录了转移性疾病。所有记录的转移均为II期和复发性黑色素瘤。除2例骨转移和1例脑转移外，所有有转移记录的患者术后测定的血清乳酸脱氢酶水平均大于300 U/L。我们的结论是，鉴于低收益率，有没有常规转移后处理的作用，以检测沉默转移恶性黑色素瘤。术后血清乳酸脱氢酶水平升高表明需要进行转移性检查。
To evaluate the role of staging workup in primary and recurrent malignant melanoma, we reviewed the results in 115 patients with primary melanoma and in 28 patients with recurrent disease who underwent evaluation with chest roentgenograms, radionuclide bone and liver scans, and either a radionuclide brain scan or computed tomography of the brain. Upper gastrointestinal tract series with small-bowel follow-through were obtained in 42 patients. Metastatic disease was documented in nine of 143 chest roentgenograms, seven of 137 liver-spleen scans, three of 141 bone scans, two of 85 brain scans, two of 43 brain computed tomographic scans, and two of 42 upper gastrointestinal tract series. All documented metastasis was in stage II and recurrent melanoma. Postoperatively determined serum lactate dehydrogenase levels showed greater than 300 U/L in all patients with documented metastasis except in two with bone and one with brain metastases. We conclude that, in view of low yield, there is no role for routine metastatic workup to detect silent metastasis in malignant melanoma. Elevated postoperative serum lactate dehydrogenase levels indicate need for metastatic workup.