Cecchi Roberto, Pavesi Mario, Buralli Lauro, Innocenti Stefania, De Gaudio Cataldo
Department of Dermatology, Ospedale di Pistoia, Pistoia.
Chir Ital. 2008 Mar-Apr;60(2):257-60.
Few studies have analysed the relationship between tumour regression and risk of nodal metastasis in patients with thin melanomas (Breslow thickness < or = 1 mm), and the conclusions reported have been conflicting. The aim of this study was to evaluate the role of histological regression as a predictor of lymph node metasta- sis in a selected group of patients with thin melanomas, submitted to lymphatic mapping and sentinel lymph node biopsy. From November 1999 to November 2006, 59 patients with thin melanomas (28 females and 31 males; mean age: 58.7 years) underwent lymphatic mapping and sentinel lymph node biopsy. The mean Breslow thickness was 0.60 mm (range: 0.24-1 mm). Tumour ulceration was present in 2 patients (3.4%) and histological regression in 45 (76.3%). Sentinel lymph node metastases were detected in 2 of 59 patients (3.4%), but only one patient with a positive sentinel lymph node exhibited histological regression of his tumour. Therefore, the sentinel lymph node positivity rate in thin regressing melanomas was 2.2%. Literature data and our experience suggest that tumour regression is not a predictor of sentinel lymph node metastasis in patients with thin melanomas, and therefore does not justify the routine use of lymphatic mapping and sentinel lymph node biopsy in this melanoma setting.
很少有研究分析过薄型黑色素瘤（Breslow厚度≤1mm）患者肿瘤消退与淋巴结转移风险之间的关系，且所报道的结论相互矛盾。本研究的目的是评估组织学消退在一组接受淋巴管造影和前哨淋巴结活检的薄型黑色素瘤患者中作为淋巴结转移预测指标的作用。从1999年11月至2006年11月，59例薄型黑色素瘤患者（28例女性，31例男性；平均年龄：58.7岁）接受了淋巴管造影和前哨淋巴结活检。平均Breslow厚度为0.60mm（范围：0.24 - 1mm）。2例患者（3.4%）存在肿瘤溃疡，45例（76.3%）存在组织学消退。59例患者中有2例（3.4%）检测到前哨淋巴结转移，但只有1例前哨淋巴结阳性的患者其肿瘤表现出组织学消退。因此，薄型消退性黑色素瘤的前哨淋巴结阳性率为2.2%。文献数据和我们的经验表明，肿瘤消退并非薄型黑色素瘤患者前哨淋巴结转移的预测指标，因此在这种黑色素瘤情况下，并不支持常规使用淋巴管造影和前哨淋巴结活检。
