Lingam M K, Mackie R M, McKay A J
Department of Surgery, Gartnavel General Hospital, West Glasgow Hospitals University NHS Trust.
Br J Cancer. 1997;75(10):1505-8. doi: 10.1038/bjc.1997.257.
We report our experience with the technique of lymphatic mapping using patent blue V dye in patients with limb malignant melanoma. The technique is based on the hypothesis that embolic metastases occur along lymphatic channels to a 'sentinel' lymph node: the draining lymph node nearest the site of the primary malignant melanoma. Patent blue V dye (0.5-1.0 ml) is injected intradermally around the site of the melanoma. Immediately the groin or axilla is opened and the blue lymphatic channels followed to the sentinel node. The node is removed and examined by both haematoxylin and eosin (H&E) and immunohistochemical staining. We have carried out this technique in 35 patients, all of whom had 'clinically assessed' stage I disease. In all 35 patients, sentinel nodes were identified, and nine were found to contain unsuspected micrometastases. Our initial evaluation of intraoperative lymphatic mapping is very promising. The technique is practicable and easy to master. If 25% of patients with cutaneous malignant melanoma who are clinically stage I have nodal disease, this has great importance not only for staging and treatment but also for all future therapeutic trials.
我们报告了在肢体恶性黑色素瘤患者中使用专利蓝V染料进行淋巴绘图技术的经验。该技术基于这样的假设，即栓塞性转移沿着淋巴管发生至“前哨”淋巴结：即离原发性恶性黑色素瘤部位最近的引流淋巴结。将专利蓝V染料（0.5 - 1.0毫升）皮内注射到黑色素瘤部位周围。随后立即打开腹股沟或腋窝，顺着蓝色淋巴管找到前哨淋巴结。切除该淋巴结并进行苏木精和伊红（H&E）染色以及免疫组化染色检查。我们对35例患者实施了这项技术，所有患者均经“临床评估”为I期疾病。在所有35例患者中均识别出了前哨淋巴结，其中9例发现含有未被怀疑的微转移灶。我们对术中淋巴绘图的初步评估很有前景。该技术切实可行且易于掌握。如果25%临床I期的皮肤恶性黑色素瘤患者存在淋巴结疾病，这不仅对分期和治疗而且对所有未来的治疗试验都具有重要意义。
