Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan.
Int J Clin Oncol. 2009 Oct;14(5):426-30. doi: 10.1007/s10147-009-0894-3. Epub 2009 Oct 25.
High-frequency sonographic imaging has been used for the preoperative evaluation of primary malignant melanoma. In the present study, to identify the usefulness of 30-MHz sonography for determination of the surgical margin and indication for sentinel lymph node biopsy, the correlation between sonometric and histometric tumor thickness was investigated.
A total of 74 primary melanomas, in patients seen at the dermatology clinic, Shinshu University Hospital, from 1998 to 2006, were evaluated using high-frequency sonographic equipment with two probes (15 MHz and 30 MHz), and tumor thickness was measured using electronic calipers before surgical treatment. All the primary lesions were surgically excised and Breslow's tumor thickness was measured histologically.
In 68 melanomas, excluding 2 lesions of melanoma in situ and 4 lesions with poor sonographic images, sonographic and histologic thickness showed good correlation (r = 0.887). Particularly, in 26 melanomas affecting the soles of the feet, sonographic and histologic thickness showed excellent correlation (r = 0.945). Regarding the T categorization, in which T1-T4 are divided at 1, 2, and 4 mm in thickness, the categories determined with sonometry corresponded very well to those determined with histometry. The correspondence was particularly excellent in thinner primary lesions with thickness around 1 mm. We excised almost all these primary melanomas with surgical margins based on the sonometric thickness. In 22 patients with sonometric thickness more than 1 mm, sentinel lymph node biopsy and/or radical lymphadenectomy was performed.
High-frequency sonography (30-MHz) is very useful in the preoperative prediction of tumor thickness, particularly in thinner primary lesions, which allows us to determine surgical margins and indication for sentinel lymph node biopsy.
高频超声成像已用于原发性恶性黑色素瘤的术前评估。在本研究中，为了确定 30MHz 超声在确定手术切缘和前哨淋巴结活检适应证方面的作用，我们研究了超声测量值与组织学测量值之间的相关性。
对 1998 年至 2006 年间在日本信州大学医院皮肤科诊所就诊的 74 例原发性黑色素瘤患者进行高频超声（15MHz 和 30MHz 两种探头）检查，在手术治疗前使用电子卡尺测量肿瘤厚度。所有原发性病变均行手术切除，Breslow 肿瘤厚度采用组织学方法进行测量。
在 68 例黑色素瘤中，除 2 例原位黑色素瘤和 4 例超声图像质量差的病变外，超声和组织学厚度均有良好的相关性（r=0.887）。特别是在 26 例影响足底的黑色素瘤中，超声和组织学厚度相关性非常好（r=0.945）。在 T 分类中，厚度在 1、2 和 4mm 处分别为 T1、T2 和 T4，超声测量的 T 分类与组织学测量的 T 分类非常吻合。在厚度约 1mm 的较薄原发性病变中，吻合度特别好。我们根据超声测量值切除了几乎所有这些原发性黑色素瘤的手术切缘。在 22 例超声测量值大于 1mm 的患者中，进行了前哨淋巴结活检和/或根治性淋巴结切除术。
高频超声（30MHz）在术前预测肿瘤厚度方面非常有用，特别是在较薄的原发性病变中，这有助于我们确定手术切缘和前哨淋巴结活检的适应证。
