Department of Ocular Oncology, St Bartholomew's Hospital and Moorfields Eye Hospital London, , London, UK.
Br J Ophthalmol. 2013 Dec;97(12):1525-9. doi: 10.1136/bjophthalmol-2013-303671. Epub 2013 Sep 24.
To report our experience with sentinel lymph node biopsy for staging patients with conjunctival melanoma.
A prospective review of patients with conjunctival melanoma who underwent sentinel lymph node biopsy at St Bartholomew's Hospital from May 2008 to May 2012. The selection criterion for sentinel node biopsy depended on the tumour thickness (≥2 mm) and location of the conjunctival melanoma. The main outcome measures were the incidence of sentinel lymph node positivity and the procedure-related complications.
In 4 years, 26 out of 70 patients met the selection criteria for sentinel lymph node biopsy. 4 patients declined and 22 patients consented for the procedure. Technetium-99m failed to identify a sentinel lymph node in four of the 22 patients (18%). Of the remaining 18 patients, two were found to have subclinical micrometastasis in regional lymph nodes. Median follow-up was 20 months (range 6-36 months). No false-negative events were observed. Complications of the procedure included transient blue staining of the epibulbar surface in five patients and transient facial nerve palsy in one patient.
Sentinel lymph node biopsy is a safe procedure with minimal complications. It should be considered for the staging of conjunctival melanomas, especially melanomas in non-limbal location or conjunctival melanomas ≥2 mm thick.
报告我们在结膜黑色素瘤患者分期中应用前哨淋巴结活检术的经验。
对 2008 年 5 月至 2012 年 5 月在圣巴塞洛缪医院接受前哨淋巴结活检术的结膜黑色素瘤患者进行前瞻性回顾。前哨淋巴结活检术的选择标准取决于肿瘤厚度（≥2mm）和结膜黑色素瘤的位置。主要观察指标为前哨淋巴结阳性率和与该操作相关的并发症。
4 年来，70 例患者中有 26 例符合前哨淋巴结活检术的选择标准。有 4 例患者拒绝，22 例患者同意进行该操作。22 例患者中有 4 例（18%）锝-99m 未能识别出前哨淋巴结。其余 18 例患者中，有 2 例发现局部淋巴结有临床前微转移。中位随访时间为 20 个月（6-36 个月）。未观察到假阴性事件。该操作的并发症包括 5 例眼表一过性蓝色染色和 1 例一过性面神经瘫痪。
前哨淋巴结活检术是一种安全的操作，并发症少。对于结膜黑色素瘤的分期，特别是非角膜缘位置的黑色素瘤或厚度≥2mm 的结膜黑色素瘤，应考虑该操作。
