Berghe Alexandra S, Cobzac Gheorghe, Dindelegan George, Șenilă Simona C, Baican Corina I, Solomon Carolina M, Rogojan Liliana, Leucuța Daniel C, Drugan Tudor C, Bolboacă Sorana D
Department of Medical Informatics and Biostatistics, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
Department of Nuclear Medicine, County Emergency Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania.
Exp Ther Med. 2021 Jul;22(1):730. doi: 10.3892/etm.2021.10162. Epub 2021 May 5.
The aim of the present study was to assess the influence of localization, age or sex and histopathological characteristics upon the chance of developing lymphatic or hematogenous metastatic spread over time, or a positive sentinel lymph node in cutaneous melanoma patients. Patients from the Department of Dermatology, County Emergency Hospital Cluj-Napoca (Cluj-Napoca, Romania), presenting with cutaneous melanoma confirmed histopathologically and a SPECT/CT or lymphoscintigraphic examination to detect the sentinel lymph node, were included in the present study. Our results revealed that Breslow index >2 mm [odds ratio (OR)=4.22, 95% confidence interval (CI) (1.12; 15.93)], presence of ulceration [OR=6.01, 95% CI (1.87; 19.35)], and positive sentinel lymph node [for at least one sentinel lymph node OR=3.58, 95% CI (1.06; 12.04)] were risk factors for hematogenous metastases. All these, except for the Breslow index >2 mm, were demonstrated to be a risk factor for lymphatic spread metastases over time. Ulceration and male sex also represented risk factors for a positive sentinel lymph node, men having a higher risk of developing sentinel lymph nodes than women [adjusted OR=2.27, 95% CI (1.00; 5.13)]. In conclusion, the predictors that influence the occurrence of lymphatic or hematogenous metastases may differ, ulceration and positive sentinel lymph node being common for both types of metastatic spread, while Breslow index being a significant predictor only for hematogenous metastases. Male sex and the presence of ulceration were demonstrated to be significant risk factors for positive sentinel lymph nodes.
本研究的目的是评估在一段时间内，肿瘤定位、年龄、性别及组织病理学特征对皮肤黑色素瘤患者发生淋巴或血行转移扩散的可能性，或前哨淋巴结阳性的影响。来自克卢日-纳波卡县急诊医院皮肤科（罗马尼亚克卢日-纳波卡）的患者，经组织病理学确诊为皮肤黑色素瘤，并接受了SPECT/CT或淋巴闪烁成像检查以检测前哨淋巴结，被纳入本研究。我们的结果显示， Breslow指数>2 mm [比值比（OR）=4.22，95%置信区间（CI）（1.12；15.93）]、溃疡的存在[OR=6.01，95% CI（1.87；19.35）]以及前哨淋巴结阳性[至少一个前哨淋巴结OR=3.58，95% CI（1.06；12.04）]是血行转移的危险因素。除Breslow指数>2 mm外，所有这些因素均被证明是随时间推移发生淋巴转移扩散的危险因素。溃疡和男性也是前哨淋巴结阳性的危险因素，男性发生前哨淋巴结转移的风险高于女性[校正OR=2.27，95% CI（1.00；
