Bohelay Gérôme, Battistella Maxime, Pagès Cécile, de Margerie-Mellon Constance, Basset-Seguin Nicole, Viguier Manuelle, Kerob Delphine, Madjlessi Nika, Baccard Michel, Archimbaud Alain, Comte Christelle, Mourah Samia, Porcher Raphael, Bagot Martine, Janin Anne, De Kerviler Eric, Lebbé Céleste
aAP-HP, Oncodermatology Unit, Dermatology Department bAP-HP, Pathology Department cAP-HP, Radiology Department dAP-HP, Pharmacology-Genetic Laboratory eAP-HP, Department of Biostatistics and Medical Data Processing, Saint-Louis Hospital, Paris 7 Diderot University fParis Diderot University, Sorbonne Paris Cité, UMR-S 728 gParis Diderot University, Sorbonne Paris Cité, UMR 976 hINSERM, U728 iINSERM, U976, Paris, France.
Melanoma Res. 2015 Dec;25(6):519-27. doi: 10.1097/CMR.0000000000000161.
To investigate the diagnostic value of ultrasound-guided core needle biopsy (US-CNB) in suspected cases of lymph node metastasis from cutaneous melanoma. All patients with cutaneous melanoma followed in Saint-Louis Hospital between 2006 and 2010 who underwent US-CNB for suspicion of melanoma lymph node metastasis were reviewed retrospectively. Histopathological results of US-CNB samples were classified as melanoma, other malignancy, suspicious, inadequate, or benign. The diagnostic accuracy of US-CNB was assessed by comparison with two reference standards: histopathological examination of the radical lymph node dissection or, when this was not available, clinical and radiological follow-up. The data from 72 US-CNB were analyzed. Forty-four melanomas, 22 benign, three other malignancies, three inadequate samples, and no inconclusive specimens were diagnosed. Seventy-one US-CNB results were confirmed (98.6%). US-CNB achieved high sensitivity, specificity, and positive predictive value (respectively, 97.9, 100, and 100%). No adverse events were reported after the procedure. US-CNB provided a mean tissue volume of 16.7 mm per lymphadenopathy. US-CNB has diagnostic value similar to that of fine-needle aspiration cytology. It represents a reliable alternative method in melanoma lymph node metastasis to avoid surgery in patients who will not benefit from it. US-CNB provides relatively large samples of tissue suitable for comprehensive genomic analyses currently needed for research and personalized care of melanoma patients.
探讨超声引导下粗针穿刺活检（US-CNB）在皮肤黑色素瘤疑似淋巴结转移病例中的诊断价值。对2006年至2010年在圣路易医院随访的所有因疑似黑色素瘤淋巴结转移而接受US-CNB的皮肤黑色素瘤患者进行回顾性研究。US-CNB样本的组织病理学结果分为黑色素瘤、其他恶性肿瘤、可疑、不充分或良性。通过与两个参考标准进行比较来评估US-CNB的诊断准确性：根治性淋巴结清扫的组织病理学检查，或者在无法进行该检查时，进行临床和影像学随访。分析了72例US-CNB的数据。诊断出44例黑色素瘤、22例良性、3例其他恶性肿瘤、3例样本不充分，且无不确定标本。71例US-CNB结果得到证实（98.6%）。US-CNB具有较高的敏感性、特异性和阳性预测值（分别为97.9、100和100%）。术后未报告不良事件。US-CNB每个淋巴结病变提供的平均组织体积为16.7立方毫米。US-CNB的诊断价值与细针穿刺细胞学检查相似。它是黑色素瘤淋巴结转移的一种可靠替代方法，可避免对无法从中受益的患者进行手术。US-CNB提供相对较大的组织样本，适合目前黑色素瘤患者研究和个性化治疗所需的综合基因组分析。
