Department of Surgery, University of Alberta Hospital, 8440-112th St. Edmonton AB T6G 2B7.
Can J Surg. 2010 Feb;53(1):32-6.
Several studies have examined the correlation between patient and tumour characteristics and sentinel lymph node (SLN) metastasis in patients with melanoma. Although most studies have identified Breslow thickness as an important factor, results for other variables have been conflicting. Much of this variability is probably because of differences in measurement techniques and reporting practices at different institutions. We sought to identify the predictors of SLN melanoma metastasis in our institution and patient population.
We performed a retrospective chart review of 348 patients with malignant melanoma who underwent SLN biopsy at a single institution from January 1999 to April 2007. We compared multiple variables related to patient demographics, primary tumour characteristics and SLN characteristics between patients in the positive and negative SLN groups.
Breslow thickness and nodular tumour type were independent factors significantly correlated with a positive SLN biopsy result in our study. Head and neck tumour location correlated with a lower likelihood of positive SLN status in univariate but not multivariate analyses.
This study confirms the status of Breslow thickness as a reproducible predictor of positive SLN status. We also found that nodular type was predictive of positive SLN status, an outcome that has not been reported by others.
已有多项研究探讨了黑色素瘤患者的患者和肿瘤特征与前哨淋巴结(SLN)转移之间的相关性。尽管大多数研究都确定了 Breslow 厚度是一个重要因素,但其他变量的结果却存在冲突。这种变异性很大程度上可能是由于不同机构之间测量技术和报告实践的差异所致。我们试图确定我们机构和患者人群中 SLN 黑色素瘤转移的预测因素。
我们对 1999 年 1 月至 2007 年 4 月在一家机构接受 SLN 活检的 348 例恶性黑色素瘤患者进行了回顾性图表审查。我们比较了阳性和阴性 SLN 组患者的多个与患者人口统计学、原发肿瘤特征和 SLN 特征相关的变量。
在我们的研究中,Breslow 厚度和结节型肿瘤是与 SLN 活检阳性结果显著相关的独立因素。头颈部肿瘤位置在单变量分析中与 SLN 阳性状态的可能性降低相关,但在多变量分析中不相关。
本研究证实了 Breslow 厚度作为预测 SLN 阳性状态的可重复指标的地位。我们还发现结节型是预测 SLN 阳性状态的指标,这是其他人没有报道过的结果。