薄型黑色素瘤前哨淋巴结阳性的预测因素。
Predictors of positive sentinel lymph node in thin melanoma.
机构信息
Division of Surgical Oncology, Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
出版信息
Am J Surg. 2011 Mar;201(3):324-7; discussion 327-8. doi: 10.1016/j.amjsurg.2010.09.011.
BACKGROUND
The treatment of thin melanoma (Breslow thickness <1.0 mm) may include sentinel lymph node (SLN) biopsy (SLNB). The validity of SLNB for thin melanoma remains widely debated. The purpose of this study was to elucidate pathologic factors that are predictive of SLN positivity.
METHODS
A retrospective analysis of a prospective database revealed 1,199 patients diagnosed with primary cutaneous melanoma. Multiple logistic regression was used to determine an association between pathologic factors and SLN positivity.
RESULTS
Thin melanomas were identified in 469 patients (39%). Of these, 147 patients (31%) underwent SLNB. Positive SLNs were found in 16 patients (11%). Multiple logistic regression demonstrated that both ulceration (odds ratio, 5.27; P = .047) and thickness (odds ratio, 46.69; P = .022) were associated with SLN positivity.
CONCLUSIONS
Patients with thin melanomas >.75 mm and/or ulceration should be considered for SLNB.
背景
薄型黑色素瘤（Breslow 厚度<1.0mm）的治疗可能包括前哨淋巴结（SLN）活检（SLNB）。SLNB 对薄型黑色素瘤的有效性仍存在广泛争议。本研究旨在阐明预测 SLN 阳性的病理因素。
方法
对一个前瞻性数据库进行回顾性分析，共纳入 1199 例原发性皮肤黑色素瘤患者。采用多因素逻辑回归分析来确定病理因素与 SLN 阳性之间的关联。
结果
在 469 例（39%）薄型黑色素瘤患者中，有 147 例（31%）患者行 SLNB。16 例（11%）患者的 SLN 阳性。多因素逻辑回归分析显示，溃疡（比值比，5.27；P=0.047）和厚度（比值比，46.69；P=0.022）均与 SLN 阳性相关。
结论
对于>0.75mm 且/或有溃疡的薄型黑色素瘤患者，应考虑行 SLNB。
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