摘要
目的探讨改良肢端恶性黑色素瘤前哨淋巴结活组织检查(SLNB)应用的可行性。方法回顾性分析2017年1月至2020年1月新疆医科大学附属肿瘤医院行手术治疗的60例肢端恶性黑色素瘤患者资料,根据前哨淋巴结(SLN)检测方法分为观察组(30例)及对照组(30例)。观察组使用超声造影联合亚甲蓝在腕关节或踝关节周围皮下注射法检测SLN;对照组采用亚甲蓝瘤周注射法检测SLN。采用定期复查随访的方式对患者进行术后效果评价。比较两组的SLN检出数、检出率、灵敏度、假阴性率和SLN的大小。结果观察组SLN检出率为100.0%(30/30),灵敏度为87.5%(7/8),假阴性率为3.3%(1/30);对照组SLN检出率为83.3%(25/30),灵敏度为62.5%(5/8),假阴性率为12.0%(3/25);差异均有统计学意义(均P<0.05)。观察组SLN检出数为(3.5±1.2)枚,多于对照组的(2.0±1.1)枚,差异有统计学意义(t=7.121,P<0.05)。观察组检出的SLN最小长径为(5.4±2.2)mm,范围1.5~12.3 mm;对照组为(11.8±5.4)mm,范围10.0~16.8 mm,两组差异有统计学意义(t=6.353,P<0.05)。结论改良肢端恶性黑色素瘤SLNB相比于瘤周注射法在肢端SLN检测中有较高的应用价值,可获得较高的准确率。
Objective To explore the application feasibility of modified sentinel lymph node biopsy(SLNB)for acral malignant melanoma.Methods The data of 60 patients with acral malignant melanoma in the Affiliated Tumor Hospital of Xinjiang Medical University from January 2017 to January 2020 were retrospectively analyzed.According to the sentinel lymph node(SLN)detection method,they were divided into observation group(30 cases)and control group(30 cases).The observation group used contrast-enhanced ultrasound combined with subcutaneous injection of methylene blue around the wrist or ankle joint to detect SLN;the control group used peritumoral injection of methylene blue to detect SLN.The patients were regularly followed up to evaluate the postoperative effect.The detection number,detection rate,sensitivity,false negative rate and the size of SLN were compared between the two groups.Results In the observation group,the detection rate of SLN was 100.0%(30/30),the sensitivity was 87.5%(7/8),and the false negative rate was 3.3%(1/30);in the control group,the detection rate of SLN was 83.3%(25/30),the sensitivity was 62.5%(5/8),and the false negative rate was 12.0%(3/25);the differences were statistically significant(all P<0.05).The number of SLN detected in the observation group(3.5±1.2)was significantly more than that in the control group(2.0±1.1),and the difference was statistically significant(t=7.121,P<0.05).The minimum long-axis diameter of SLN detected in the observation group was(5.4±2.2)mm(range,1.5-12.3 mm),and that in the control group was(11.8±5.4)mm(range,10.0-16.8 mm),the difference between the two groups was statistically significant(t=6.353,P<0.05).Conclusion The modified SLNB for acral malignant melanoma has a higher application value in the detection of acral SLN than the peritumoral injection method,and a higher accuracy rate can be obtained.
作者
王磊
孙亚超
武峻申
戴志兵
江仁兵
张强
Wang Lei;Sun Yachao;Wu Junshen;Dai Zhibing;Jiang Renbing;Zhang Qiang(Department of Bone and Soft Tissue,Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《肿瘤研究与临床》
CAS
2021年第4期292-295,共4页
Cancer Research and Clinic
基金
新疆维吾尔自治区自然科学基金(2016D01C357)。
