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基于临床研究的前哨淋巴结活检在皮肤癌中的作用。

Role of Sentinel Lymph Node Biopsy for Skin Cancer Based on Clinical Studies.

作者信息

Ishizuki Shoichiro, Nakamura Yoshiyuki

机构信息

Department of Dermatology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.

出版信息

Cancers (Basel). 2023 Jun 22;15(13):3291. doi: 10.3390/cancers15133291.

Abstract

The sentinel lymph node is the first lymph node from the primary tumor. Sentinel lymph node biopsy (SLNB) is a surgical procedure that can detect occult nodal metastasis with relatively low morbidity. It may also have a therapeutic effect via regional disease control. The Multicenter Selective Lymphadenectomy-I (MSLT-I) trial revealed a prognostic benefit from SLNB in melanoma patients. However, it remains unclear whether there is a prognostic benefit from SLNB in patients with nonmelanoma skin cancer owing to a lack of randomized prospective studies. Nevertheless, SLNB provides important information about nodal status, which is one of the strongest factors to predict prognosis and may guide additional nodal treatment. Currently, SLNB is widely used in the management of not only patients with melanoma but also those with nonmelanoma skin cancer. However, the utilization and outcomes of SLNB differ among skin cancers. In addition, SLNB is not recommended for routine use in all patients with skin cancer. In this review, we provide a summary of the role of SLNB and of the indications for SLNB in each skin cancer based on previously published articles.

摘要

前哨淋巴结是距离原发肿瘤最近的淋巴结。前哨淋巴结活检(SLNB)是一种外科手术,能够以相对较低的发病率检测隐匿性淋巴结转移。它还可能通过区域疾病控制发挥治疗作用。多中心选择性淋巴结清扫术-I(MSLT-I)试验显示,SLNB对黑色素瘤患者有预后益处。然而,由于缺乏随机前瞻性研究,目前尚不清楚SLNB对非黑色素瘤皮肤癌患者是否有预后益处。尽管如此,SLNB可提供有关淋巴结状态的重要信息,这是预测预后的最强因素之一,并且可能指导进一步的淋巴结治疗。目前,SLNB不仅广泛应用于黑色素瘤患者的治疗,也用于非黑色素瘤皮肤癌患者的治疗。然而,SLNB在不同皮肤癌中的应用情况和结果有所不同。此外,不建议对所有皮肤癌患者常规使用SLNB。在这篇综述中,我们根据先前发表的文章,总结了SLNB的作用以及每种皮肤癌中SLNB的适应证。

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