University Department of Surgery, Royal Free and University College London Medical School, London, UK.
World J Surg. 2011 Jun;35(6):1159-68; discussion 1155-8. doi: 10.1007/s00268-011-0956-3.
Sentinel lymph node biopsy (SLNB) is the accepted standard of care in early-stage breast cancer and cutaneous melanoma. This technology is accurate for nodal staging and determining the prognosis of these patients. There are several randomized controlled trials confirming the accuracy of this technique and confirming its role in reducing morbidity and improving quality of life. It is also gaining increased acceptance in the management of other solid tumors. Despite the established benefits of SLNB as a minimally invasive approach for nodal staging, the procedure is still underutilized in many developing countries.
The Human Health Division of the International Atomic Energy Agency (IAEA) convened advisory meetings with panels of multidisciplinary experts from different backgrounds with the remit to analyze the difficulties encountered by developing countries in establishing a successful SLNB program. The other remit of the panel was to recommend an effective program based on existing evidence that can be adapted and implemented in developing countries. The experience of some members of the panel in the training for this technique in Asia, Latin America, and Africa provided the insight required for the development of a comprehensive and structured program. The panel included recommendations on the technical aspects of the procedure, as well as a comprehensive training program, including theoretical teaching, practical training in surgical skills, laboratories, and hands-on proctored learning. Particular emphasis was placed on in-built quality assurance requirements to ensure that this powerful staging investigation is implemented with the highest possible standard in the management of cancer patients, with the lowest false negative rate.
It is hoped that this article will be a useful resource for our colleagues planning to establish a SLNB program.
前哨淋巴结活检（SLNB）是早期乳腺癌和皮肤黑色素瘤的标准治疗方法。这项技术在淋巴结分期和确定患者预后方面具有较高的准确性。有几项随机对照试验证实了该技术的准确性，并证实了其在降低发病率和提高生活质量方面的作用。它在其他实体瘤的治疗中也越来越被接受。尽管 SLNB 作为一种微创的淋巴结分期方法具有明确的益处，但在许多发展中国家，该技术的应用仍然不足。
国际原子能机构（IAEA）人类健康司召集了由来自不同背景的多学科专家组成的咨询会议，任务是分析发展中国家在建立成功的 SLNB 计划方面所面临的困难。专家组的另一个任务是根据现有证据，推荐一个可以在发展中国家适应和实施的有效计划。专家组的一些成员在亚洲、拉丁美洲和非洲培训该技术的经验为制定一个全面和结构化的计划提供了必要的见解。该小组提出了关于该程序技术方面的建议，以及一个全面的培训计划，包括理论教学、手术技能的实践培训、实验室和实际指导学习。特别强调了内置的质量保证要求，以确保在癌症患者的管理中，以最高标准实施这种强大的分期检查，并将假阴性率降至最低。
希望本文能为计划建立 SLNB 计划的同事提供有用的资源。
