- Universidade Estadual de Campinas, Departamento de Cirurgia Geral - Área de Cabeça e Pescoço - Campinas - SP - Brasil.
- Universidade Estadual de Campinas, Departamento de Patologia - Campinas - SP - Brasil.
Rev Col Bras Cir. 2023 Jul 10;50:e20233521. doi: 10.1590/0100-6991e-20233521-en. eCollection 2023.
cutaneous melanoma (MC) is a malignant neoplasm derived from melanocytic cells with an aggressive behavior. It is usually associated with the multifactorial interaction of genetic susceptibility and environmental exposure, usually ultraviolet radiation. Despite advances in treatment, the disease remains relentless with poor prognosis. Sentinel lymph node (SLN) biopsy is a technique used to screen patients in need of lymph node dissection.
to correlate the tumor burden in the SLN with the mortality of patients undergoing SLN biopsy.
the medical records and histological slides of patients with MC who underwent SLN biopsy treated at HC-Unicamp from 2001 to 2021 were retrospectively analyzed. The positive SLN were measured according to the size of the tumor infiltration area, for analysis of the depth of invasion (DI), closest proximity to the capsule (CPC) and tumor burden (TB). For statistical analysis, associations between variables were analyzed using Fishers exact test, with post Bonferroni test and Wilcoxon test.
105 records of patients who underwent SLN biopsy of MC were identified. Of these, nine (8.6%) had positive SLN and 81 (77.1%) had negative SLN. The performed lymphadenectomies resulted in 55.6% (n=5) affected, 22.2% (n=2) without disease and 22.2% (n=2) were not performed. Mean CPC, TB, and DI were 0.14mm, 32.10mm and 2.33mm, respectively. Patients with T2 and T3 tumors were more likely to show the SLN affected (p=0.022). No patient with positive SLN died during follow-up.
patients who presented T3 staging are the ones who most presented positive SLN.
皮肤黑色素瘤（MC）是一种源自黑色素细胞的恶性肿瘤，具有侵袭性。它通常与遗传易感性和环境暴露的多因素相互作用有关，通常是紫外线辐射。尽管治疗取得了进展，但该疾病仍然无情，预后不良。前哨淋巴结（SLN）活检是一种用于筛选需要淋巴结清扫的患者的技术。
将 SLN 中的肿瘤负担与接受 SLN 活检的患者的死亡率相关联。
回顾性分析了 2001 年至 2021 年在 HC-Unicamp 接受 SLN 活检治疗的 MC 患者的病历和组织学切片。根据肿瘤浸润面积的大小测量阳性 SLN，用于分析侵袭深度（DI）、最接近包膜的距离（CPC）和肿瘤负担（TB）。为了进行统计分析，使用 Fisher 确切检验分析变量之间的关联，并用 post Bonferroni 检验和 Wilcoxon 检验进行检验。
确定了 105 例接受 MC 前哨淋巴结活检的患者记录。其中，9 例（8.6%）SLN 阳性，81 例（77.1%）SLN 阴性。进行的淋巴结切除术导致 55.6%（n=5）受累、22.2%（n=2）无疾病和 22.2%（n=2）未进行。平均 CPC、TB 和 DI 分别为 0.14mm、32.10mm 和 2.33mm。T2 和 T3 期肿瘤患者更有可能出现 SLN 受累（p=0.022）。在随访期间，没有阳性 SLN 的患者死亡。
表现为 T3 分期的患者最有可能出现阳性 SLN。
