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腹腔镜检查在80例恶性黑色素瘤肝转移诊断中的应用

Laparoscopy in the diagnosis of liver metastases in 80 cases of malignant melanoma.

作者信息

Bleiberg H, La Meir E, Lejeune F

出版信息

Endoscopy. 1980 Sep;12(5):215-8. doi: 10.1055/s-2007-1021746.

Abstract

80 patients with histologically proven malignant melanoma were submitted to laparoscopy. 44 had advanced disease and 36 were clinically locoregional (23 stage I, 13 stage IIb). Results of a liver scan and liver function tests were available before starting this procedure. In all cases, biopsies were obtained through the laparoscope using a Menghini liver biopsy needle, specimens, being taken under visual control from the macroscopically suspected area. If no lesions was seen, two needle biopsies were taken at random from the anterior and posterior areas of both lobes. The liver was invaded in 11% of the patients with advanced disease, and in 23% of those with stage IIb. All the positve laparscopies occurred with biochemistry and/or liver scan were also abnormal, and biopsies taken at random in normal-looking livers were all negatives. Benign tumors were found in 13% of the cases. Some of these were indistinguishable from metastatic melanoma on the basis of their maroscopic aspect alone.

摘要

80例经组织学证实为恶性黑色素瘤的患者接受了腹腔镜检查。44例为晚期疾病,36例为临床局部区域病变(23例为I期,13例为IIb期)。在开始该操作前可获得肝脏扫描和肝功能检查结果。所有病例均通过腹腔镜使用Menghini肝活检针获取活检组织,标本在直视下从肉眼怀疑的区域采集。如果未发现病变,则从两叶的前后区域随机进行两次针吸活检。晚期疾病患者中11%的肝脏受到侵犯,IIb期患者中23%的肝脏受到侵犯。所有腹腔镜检查阳性的病例其生化检查和/或肝脏扫描也均异常,而在外观正常的肝脏中随机进行的活检均为阴性。13%的病例发现了良性肿瘤。其中一些仅凭肉眼外观与转移性黑色素瘤难以区分。

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