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皮肤黑色素瘤前哨淋巴结活检的历程:从手术刀到智能技术的简要叙述性综述

The Journey of Sentinel Lymph Node Biopsy in Cutaneous Melanoma: A Brief Narrative Review from Scalpel to Smart Tech.

作者信息

Andrei Rǎzvan Ioan, Voinea Silviu Cristian, Bordea Cristian Ioan, Nodiți Aniela Roxana, Peleașă Teodora Mihaela, Blidaru Alexandru

机构信息

Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy, B-dul Eroii Sanitari 8, 050474 Bucharest, Romania.

Department of Surgical Oncology, Institute of Oncology "Prof. Dr. Al. Trestioreanu", Şos. Fundeni 252, 022328 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2025 Aug 27;61(9):1542. doi: 10.3390/medicina61091542.

Abstract

Sentinel lymph node biopsy (SLNB) has transformed the management of cutaneous melanoma, emerging as a cornerstone in evaluating regional lymphatic spread while minimizing surgical morbidity. From its theoretical foundation laid by Cabanas to its refinement and clinical validation through landmark trials, SLNB has evolved into a standard of care with significant prognostic value. This review traces the historical trajectory of SLNB, analyzes current guidelines and controversies and explores future directions. Novel imaging technologies, such as indocyanine green fluorescence and augmented reality-assisted mapping, promise to enhance accuracy and reduce invasiveness. Furthermore, the advent of effective systemic therapies and neoadjuvant protocols is reshaping the therapeutic landscape, potentially redefining the role of SLNB in melanoma management. As precision medicine advances, SLNB remains an essential procedure, with its utility continually redefined by technological innovation and evolving oncologic strategies.

摘要

前哨淋巴结活检(SLNB)改变了皮肤黑色素瘤的治疗方式,已成为评估区域淋巴转移同时将手术发病率降至最低的基石。从卡瓦尼亚斯奠定的理论基础,到通过具有里程碑意义的试验进行完善和临床验证,SLNB已发展成为具有重要预后价值的治疗标准。本综述追溯了SLNB的历史轨迹,分析了当前的指南和争议,并探索了未来的方向。新型成像技术,如吲哚菁绿荧光和增强现实辅助绘图,有望提高准确性并降低侵入性。此外,有效的全身治疗和新辅助方案的出现正在重塑治疗格局,可能重新定义SLNB在黑色素瘤治疗中的作用。随着精准医学的发展,SLNB仍然是一项必不可少的程序,其效用不断由技术创新和不断发展的肿瘤学策略重新定义。

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