Ｓｅｎｔｉｎｅｌ ｌｙｍｐｈ ｎｏｄｅ センチネルリンパ節の同定と生検を試みた３３例の検討

Abstract

In our department, sentinel lymph node (SLN) biopsy was introduced for skin cancer treatment in Oct 2000. Since then, we have used this procedure it in 33 cases (15 of SCC, 13 of MM, 2 of Paget's disease, and 2 of porocarcinoma and 1 of Merkel cell carcinoma) . We used the triple technique SLN procedure consisting of preoperative visualization of the lymph nodes (LN) from the initial site by dynamic lymphoscintigraphy, intraoperative visualization of those particular LNs with blue dye, and gamma probe detecting of the radiolabeled LNs. As a result, at least one SLN was identified in 29/33 (88%) of these patients. Three out of the 6 patients who had the initial site on the face showed negative lymphoscintigram. Three out of the 8 patients who had the initial site on the upper extremities had SLN on their upper arms in addition to the axillary region. One of the 9 patients who had the initial site on the lower extremities had SLN on the popliteal region in addition to the inguinal region. SLN biopsy improves the accuracy of staging, and identifies patients who are candidates for further surgery and/or adjuvant therapy. [Skin Cancer (Japan) 2002; 17: 144-147]