Lens M B, Dawes M, Newton-Bishop J A, Goodacre T
University of Oxford, Centre for Evidence-Based Medicine, Nuffield Department of Clinical Medicine and Department for Plastic and Reconstructive Surgery, The Oxford Radcliffe NHS Trust, Oxford, UK.
Br J Surg. 2002 Oct;89(10):1223-7. doi: 10.1046/j.1365-2168.2002.02236.x.
Sentinel lymph node biopsy (SLNB) is a minimally invasive procedure used accurately to stage nodal basins at risk of occult metastases. There are no data as yet to show a survival benefit from SLNB and its use remains controversial. If Breslow thickness of the tumour correlates well with positive SLNB, it could be used to select patients for SLNB.
A quantitative systematic review of published studies on SLNB in patients with melanoma available by September 2001 was performed.
Twelve studies containing 4218 patients with stage I and II melanoma were identified; 17.8 (95 per cent confidence interval 16.7 to 19.0) per cent of patients had nodal micrometastases detected by SLNB. The incidence of micrometastasis in sentinel nodes correlated directly with Breslow tumour thickness; it was 1.0 per cent for lesions of less than or equal to 0.75 mm, 8.3 per cent for 0.76-1.50 mm, 22.7 per cent for 1.51-4.0 mm and 35.5 per cent for more than 4.0 mm.
The Breslow thickness of primary melanoma predicts the presence of a sentinel node metastasis. The published data are not sufficient to demonstrate a correlation between other known prognostic indicators and a positive SLNB.
前哨淋巴结活检（SLNB）是一种微创手术，用于准确分期有隐匿性转移风险的淋巴结区域。目前尚无数据表明SLNB能带来生存获益，其应用仍存在争议。如果肿瘤的 Breslow 厚度与 SLNB 阳性密切相关，那么它可用于选择适合进行 SLNB 的患者。
对截至2001年9月已发表的关于黑色素瘤患者 SLNB 的研究进行了定量系统评价。
共纳入12项研究，包含4218例I期和II期黑色素瘤患者；SLNB 检测到17.8%（95%置信区间16.7%至19.0%）的患者存在淋巴结微转移。前哨淋巴结微转移的发生率与 Breslow 肿瘤厚度直接相关；肿瘤厚度小于或等于0.75 mm的患者微转移发生率为1.0%，0.76 - 1.50 mm的为8.3%，1.51 - 4.0 mm的为22.7%，大于4.0 mm的为35.5%。
原发性黑色素瘤的 Breslow 厚度可预测前哨淋巴结转移的存在。已发表的数据不足以证明其他已知预后指标与 SLNB 阳性之间存在相关性。
