Tunn P-U, Andreou D, Illing H, Fleige B, Dresel S, Schlag P M
Department of Surgery and Surgical Oncology, Robert-Rössle-Klinik, Charité Campus Buch, Universitätsmedizin Berlin, Schwanebecker Chaussee 50, 13125 Berlin, Germany.
Eur J Surg Oncol. 2008 Jun;34(6):704-7. doi: 10.1016/j.ejso.2007.07.014. Epub 2007 Sep 17.
To examine the relevance of sentinel node biopsy in patients with synovial sarcoma.
Between July 2004 and February 2007 11 consecutive patients with synovial sarcoma treated in our clinic underwent sentinel node biopsy after a preoperative lymphoscintigraphy. A handheld gamma-probe was used during the procedure to identify the sentinel nodes, which were then resected and submitted for histopathologic evaluation.
At least one sentinel node was identified in every patient. Of a total of 15 sentinels, one was positive and 14 negative. The patient with the positive sentinel underwent a regional lymph node dissection and remains disease-free 17 months later. One patient developed regional nodal metastases despite negative sentinel node biopsy and died 12 months after the procedure. No biopsy-associated complications were observed.
Sentinel node biopsy can be successfully and safely applied to patients with synovial sarcoma. Further prospective studies are required to determine the optimal treatment approach, the false negative rate and the prognostic significance of a positive sentinel node biopsy.
探讨前哨淋巴结活检在滑膜肉瘤患者中的相关性。
2004年7月至2007年2月期间，我们诊所连续治疗的11例滑膜肉瘤患者在术前淋巴闪烁显像后接受了前哨淋巴结活检。术中使用手持式γ探测器识别前哨淋巴结，然后将其切除并进行组织病理学评估。
每位患者至少识别出一个前哨淋巴结。在总共15个前哨淋巴结中，1个为阳性，14个为阴性。前哨淋巴结阳性的患者接受了区域淋巴结清扫，17个月后仍无疾病。1例患者尽管前哨淋巴结活检为阴性，但仍发生了区域淋巴结转移，并在手术后12个月死亡。未观察到与活检相关的并发症。
前哨淋巴结活检可以成功且安全地应用于滑膜肉瘤患者。需要进一步的前瞻性研究来确定最佳治疗方法、假阴性率以及前哨淋巴结活检阳性的预后意义。
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