Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Am Acad Dermatol. 2010 May;62(5):723-34; quiz 735-6. doi: 10.1016/j.jaad.2009.11.695.
Sentinel lymph node biopsy for melanoma was introduced in the early 1990s as a minimally invasive method of identifying and pathologically staging regional lymph node basins in patients with clinical stage I/II melanoma. Numerous large trials have demonstrated that sentinel lymph node evaluation has utility in improving accuracy of prognostication and for risk stratifying patients into appropriate groups for clinical trials. However, there remains a great deal of controversy regarding the therapeutic role of removal of the remainder of locoregional lymph nodes should metastatic cells be identified in the sentinel node. This CME article will outline a brief history of the sentinel node concept before reviewing updates in surgical technique, histopathologic evaluation of nodal tissue, and cost effectiveness of sentinel node biopsy.
After completing this learning activity, participants should be able to describe the concept of sentinel lymph node biopsy, to discuss the risks and benefits associated with this procedure, and to summarize the role of sentinel lymph node biopsy in management of patients with melanoma.
介绍黑色素瘤前哨淋巴结活检术的概念，讨论该手术的风险与获益，并总结前哨淋巴结活检术在黑色素瘤患者管理中的作用。
黑色素瘤前哨淋巴结活检术于 20 世纪 90 年代初引入，是一种微创方法，可用于识别和对临床 I/II 期黑色素瘤患者的区域淋巴结进行病理分期。大量大型临床试验表明，前哨淋巴结评估有助于提高预后判断的准确性，并有助于将患者分层为适合临床试验的适当组别。然而，对于在前哨淋巴结中发现转移细胞时是否应切除局部区域淋巴结的其余部分，仍存在很大争议。本文将简要回顾前哨淋巴结概念的历史，然后综述手术技术、淋巴结组织的组织病理学评估以及前哨淋巴结活检的成本效益。
完成本项学习活动后，参与者应能够描述前哨淋巴结活检的概念，讨论与该手术相关的风险与获益，并总结前哨淋巴结活检术在黑色素瘤患者管理中的作用。
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