黑色素瘤前哨淋巴结活检的意义

Significance of sentinel lymph node biopsy in the treatment of melanoma

黑色素瘤可发生于皮肤和黏膜,是目前发病率增长较快、易早期淋巴结转移的恶性肿瘤。淋巴结状态的评估对于黑色素瘤的分期和治疗具有重要意义,前哨淋巴结活检(sentinel lymph node biopsy,SLNB)扮演着重要角色。目前,SLNB技术发展较快,但是SLNB阳性患者行淋巴结清扫(complete lymph node dissection,CLND)是否显著延长总生存期(overall survival,OS)仍然存在争议。全球多中心临床试验结果对前哨淋巴结阳性病例行CLND仍存争议,未得到黑色素瘤特异性生存率(melanoma specific survival,MSS)获益,但是可以确定SLNB能显著提高患者局部控制率,是现阶段循证医学证据下评估和分期的可靠方法。本文就黑色素瘤SLNB的研究进展和意义进行述评。

Melanoma, which originates from skin and mucosa, is a rapidly growing malignant tumor that exhibits early stage lymph node metastasis. The evaluation of lymph node status is critical for the staging and treatment of melanoma, and sentinel node biopsy（SLNB） plays an important role in this comprehensive diagnosis and treatment system. The SLNB technique is rapidly developing in recent years; however, whether complete lymph node dissection with positive sentinel lymph nodes significantly prolongs patients＇ overall survival remains controversial. The final results of a global, multicenter clinical trial did not support the benefit of increased diseasespecific survival rates in melanoma patients who underwent complete lymph node dissection after sentinellymph nodes were found positive. It is certain that SLNB can significantly improve local control and decrease regional recurrence and that SLNB is a reliable procedure for staging and prognosis prediction in the evidence-based medicine era. The authors review the progress and significance of research on sentinel lymph node biopsy in the treatment of melanoma.