Department of Surgery, St Vincent's Hospital, Sydney, Australia.
Department of Otolaryngology, Head and Neck Surgery, St George Hospital, Sydney, Australia.
Head Neck. 2018 Dec;40(12):2704-2713. doi: 10.1002/hed.25345. Epub 2018 Jun 22.
Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine tumor arising on the head and neck in 40%-50% of patients. Between 20% and 40% will harbor subclinical nodal metastasis.
Using search terms 'Merkel AND sentinel', MEDLINE, PUMED, and EMBASE databases were systematically reviewed for publications regarding sentinel lymph node biopsy (SLNB) in classification I and II MCC of the head and neck.
Twenty-nine publications encompassing 136 patients were included. The SLNB finding was positive in 42 patients (30.9%). Primary MCC was located on the malar/zygomatic (34.4%), forehead/frontal (13.5%), and nasal (13.5%) regions. Recurrence in an SLNB negative nodal basin result occurred in 10 patients (false negative rate of 19.2%). Site of primary MCC was not associated with a false-negative SLNB result; however, there was a non-statistically significant trend for increased frequency among midline lesions.
Sentinel lymph node biopsy (SLNB) is recommended for eligible patients with classification I and II head and neck MCC.
默克尔细胞癌（Merkel cell carcinoma，MCC）是一种罕见且侵袭性的皮肤神经内分泌肿瘤，约 40%-50%的患者发生于头颈部。20%-40%的患者存在亚临床淋巴结转移。
采用“Merkel 细胞癌 AND 前哨淋巴结”等检索词，系统检索 MEDLINE、PUBMED 和 EMBASE 数据库中有关头颈部 I 期和 II 期 MCC 前哨淋巴结活检（sentinel lymph node biopsy，SLNB）的文献。
共纳入 29 篇文献，包括 136 例患者。42 例（30.9%）SLNB 结果阳性。原发 MCC 位于颧颊部（34.4%）、额部/额区（13.5%）和鼻部（13.5%）。10 例（19.2%）SLNB 阴性淋巴结区出现复发（假阴性率）。原发 MCC 部位与 SLNB 假阴性结果无相关性；但中线病变的假阴性率呈升高趋势，但无统计学意义。
对于 I 期和 II 期头颈部 MCC 患者，建议行 SLNB。
