Voit C, Mayer T, Proebstle T M, Weber L, Kron M, Krupienski M, Zeelen U, Sterry W, Schoengen A
Department of Dermatology, Charité, Humboldt University of Berlin, Germany.
Cancer. 2000 Jun 25;90(3):186-93.
The early detection and treatment of tumor recurrences in melanoma patients is dependent on reliable, sensitive, and specific techniques to verify suspected tumor metastases. As of now, fine-needle aspiration cytology (FNAC) has yet to establish itself in the routine follow-up of melanoma patients.
FNAC procedures were performed in melanoma patients with palpable tumors or nonpalpable, ultrasonically suspicious lesions. Cytodiagnostic evaluation of fine-needle samples obtained from suspicious lesions was performed morphologically. Findings were validated either by histopathologic diagnosis or prolonged clinical follow-up.
The cytologic examination of 739 FNACs from 330 melanoma patients was conducted within 1 day of sampling. Complications were not observed. This study showed a sensitivity of 97.9% and a specificity of 100.0%. Moreover, in 158 FNACs derived from lesions with a diameter less than 1 cm a sensitivity of 94.6% was achieved. Diagnosis of metastatic melanoma with unknown primary tumor was established in 20 cases.
FNAC is very reliable for the early detection of melanoma metastases. FNAC is a swift method free of complications and is able to replace diagnostic surgery completely for nonmalignant lesions in a large number of patients. Moreover, FNAC is especially useful in combination with ultrasound in melanoma follow-up and can enable diagnosis of lesions smaller than 1 cm without impairment of sensitivity or specificity.
黑色素瘤患者肿瘤复发的早期检测和治疗依赖于可靠、敏感且特异的技术来验证疑似肿瘤转移。截至目前，细针穿刺细胞学检查（FNAC）尚未在黑色素瘤患者的常规随访中确立其地位。
对有可触及肿瘤或不可触及但超声检查可疑病变的黑色素瘤患者进行FNAC操作。对从可疑病变获取的细针样本进行形态学细胞诊断评估。通过组织病理学诊断或延长的临床随访来验证结果。
在采样1天内对330例黑色素瘤患者的739次FNAC进行了细胞学检查。未观察到并发症。本研究显示敏感性为97.9%，特异性为100.0%。此外，在158例来自直径小于1 cm病变的FNAC中，敏感性达到94.6%。确诊了20例原发肿瘤不明的转移性黑色素瘤。
FNAC在黑色素瘤转移的早期检测中非常可靠。FNAC是一种快速且无并发症的方法，在大量患者中能够完全替代非恶性病变的诊断性手术。此外，FNAC在黑色素瘤随访中与超声联合使用特别有用，能够在不损害敏感性或特异性的情况下诊断小于1 cm的病变。
