中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2014年
6期
461-464
,共4页
黑色素瘤%前哨淋巴结活组织检查%无瘤生存时间
黑色素瘤%前哨淋巴結活組織檢查%無瘤生存時間
흑색소류%전초림파결활조직검사%무류생존시간
Melanoma%Sentinel lymph node biopsy%Disease free survival
目的 评价前哨淋巴结活检术在肢体黑色素瘤治疗中的作用和意义.方法 回顾性分析2007年4月至2013年8月收治的48例肢体黑色素瘤患者的临床资料.48例患者均采用前哨淋巴结活检+手术治疗的方法.其中截指(趾)术11例,保肢术37例.采用游离植皮或转移皮瓣修复重建28例.广泛切除37例,根治性切除11例.Ⅰ、Ⅱ期39例,Ⅲ期9例.术后化疗患者9例,行白介素+干扰素治疗者26例.全组46例患者获得随访,2例失访,随访率为95.8％.随访时间2～ 60个月,平均随访时间为20.1个月.结果 在行前哨淋巴结活检阴性的39例患者中,4例发生复发或转移.而在9例前哨淋巴结活检阳性且行淋巴结清扫的患者中,3例复发.前哨淋巴结活检阴性者的术后中位无瘤生存时间为19.5个月,明显优于活检阳性者(9.5个月,P=0.030).而患者的性别和年龄与术后无瘤生存时间均无关(均P ＞0.05).结论 前哨淋巴结活检术通过放射性示踪剂的淋巴显像可以更好地掌握黑色素瘤区域淋巴结转移的情况,进而明确病理分期、指导治疗方案和评价预后.
目的 評價前哨淋巴結活檢術在肢體黑色素瘤治療中的作用和意義.方法 迴顧性分析2007年4月至2013年8月收治的48例肢體黑色素瘤患者的臨床資料.48例患者均採用前哨淋巴結活檢+手術治療的方法.其中截指(趾)術11例,保肢術37例.採用遊離植皮或轉移皮瓣脩複重建28例.廣汎切除37例,根治性切除11例.Ⅰ、Ⅱ期39例,Ⅲ期9例.術後化療患者9例,行白介素+榦擾素治療者26例.全組46例患者穫得隨訪,2例失訪,隨訪率為95.8％.隨訪時間2～ 60箇月,平均隨訪時間為20.1箇月.結果 在行前哨淋巴結活檢陰性的39例患者中,4例髮生複髮或轉移.而在9例前哨淋巴結活檢暘性且行淋巴結清掃的患者中,3例複髮.前哨淋巴結活檢陰性者的術後中位無瘤生存時間為19.5箇月,明顯優于活檢暘性者(9.5箇月,P=0.030).而患者的性彆和年齡與術後無瘤生存時間均無關(均P ＞0.05).結論 前哨淋巴結活檢術通過放射性示蹤劑的淋巴顯像可以更好地掌握黑色素瘤區域淋巴結轉移的情況,進而明確病理分期、指導治療方案和評價預後.
목적 평개전초림파결활검술재지체흑색소류치료중적작용화의의.방법 회고성분석2007년4월지2013년8월수치적48례지체흑색소류환자적림상자료.48례환자균채용전초림파결활검+수술치료적방법.기중절지(지)술11례,보지술37례.채용유리식피혹전이피판수복중건28례.엄범절제37례,근치성절제11례.Ⅰ、Ⅱ기39례,Ⅲ기9례.술후화료환자9례,행백개소+간우소치료자26례.전조46례환자획득수방,2례실방,수방솔위95.8％.수방시간2～ 60개월,평균수방시간위20.1개월.결과 재행전초림파결활검음성적39례환자중,4례발생복발혹전이.이재9례전초림파결활검양성차행림파결청소적환자중,3례복발.전초림파결활검음성자적술후중위무류생존시간위19.5개월,명현우우활검양성자(9.5개월,P=0.030).이환자적성별화년령여술후무류생존시간균무관(균P ＞0.05).결론 전초림파결활검술통과방사성시종제적림파현상가이경호지장악흑색소류구역림파결전이적정황,진이명학병리분기、지도치료방안화평개예후.
Objective To evaluate the role of sentinel lymph node biopsy (SLNB) for the treatment of melanoma of the extremities.Methods From April 2007 to August 2013,forty-eight (25 men and 23 women) cases of melanoma of the extremities underwent sentinel lymph node biopsy.All the cases had sentinel lymph node biopsy and surgery.Among them 37 cases underwent limb salvage surgery,while 11 cases underwent amputation.Of the cases with limb salvage,28 cases underwent free skin grafting or local flap grafting reconstruction after wide resection.Of the surgical margin,wide resection was performed in 37 patients,and radical resection was performed in 11 cases.There were 39 cases in stage Ⅰ or Ⅱ,and 9 cases in stage Ⅲ.After the surgery,adjuvant chemotherapy was performed in 9 cases,and adjuvant biotherapy of interferon and interleukin was performed in 26 cases.Except for 2 cases,46 cases were followed up with a mean follow-up period of 20.1 months (range from 2 to 60 months).Results 39 (81.3％) cases had negative SLNB,while 9 (18.8％) cases had positive SLNB.Recurrence or metastasis was more common in those with positive SLNB (3 of 9 cases,33.3％) compared with those with negative SLNB (4 of 39 cases,10.3％).The median disease-free survival of patients with negative results was 19.5 months,significantly longer than that of the positive cases (9.5 months,P =0.03).Otherwise,sex and age showed no significant difference in the disease free survivals.Conclusions Sentinel lymph node biopsy enables us to have a better understanding of regional lymph node status through lymphoscintigraphy.It improves the accuracy of staging and provides valuable prognostic information to guide subsequent treatment decisions.
