BACKGROUND:Ultrasonography with fine-needle aspiration cytology (FNAC) has proven to be a valuable diagnostic tool in the preoperative workup of patients with breast cancer or penile cancer eligible for sentinel lymph node biopsy. The aim of this study was to evaluate the use of this technique in the initial assessment of patients with primary cutaneous melanoma. METHODS:A total of 107 patients with cutaneous melanoma eligible for sentinel node biopsy with clinically negative nodes were studied prospectively. Patients underwent ultrasonography of potentially involved basins and FNAC in case of a suspicious lymph node. The sentinel node procedure was omitted in patients with tumour-positive lymph nodes in lieu of lymph node dissection. RESULTS:Ultrasonography with FNAC correctly identified disease preoperatively in two of the 107 patients (2%). Thirteen of the 22 patients (59%) with a suspicious node on ultrasonographic imaging but a tumour-negative fine-needle aspirate were shown to have involved nodes. Of the 85 patients with ultrasonographically normal nodes, 25 (29%) were shown to have metastases. Of the total of 43 involved basins, 16 contained metastases > 2 mm and 25 < or = 2 mm. CONCLUSIONS:In our hands, the sensitivity and specificity of preoperative ultrasonography to detect lymph node involvement in patients with melanoma are 34% and 87%, respectively. In combination with FNAC, this is 4.7% and 100%, respectively. This yield is insufficient for this technique to be used as a routine diagnostic tool in the selection of patients eligible for sentinel node biopsy.

译文

背景:超声检查结合细针穿刺细胞学检查(FNAC)已被证明是对乳腺癌或阴茎癌患者进行前哨淋巴结活检的术前检查中有价值的诊断工具。这项研究的目的是评估该技术在原发性皮肤黑素瘤患者的初步评估中的应用。
方法:前瞻性研究了107例符合临床前淋巴结活检要求的前哨淋巴结活检的皮肤黑色素瘤患者。对可疑淋巴结患者进行超声检查,包括潜在受累盆和FNAC。肿瘤阳性淋巴结代替淋巴结清扫的患者省略了前哨淋巴结清扫术。
结果:107例患者中有2例(2%)在接受FNAC的超声检查之前能正确地识别出疾病。 22例患者中有13例(59%)在超声检查中发现可疑淋巴结,但肿瘤阴性的细针抽吸物已累及淋巴结。在超声检查正常的85例患者中,有25例(29%)显示有转移。在总共43个受累盆地中,有16个包含的转移灶> 2 mm,而25个<或= 2 mm。
结论:在我们手中,术前超声检查黑色素瘤患者淋巴结受累的敏感性和特异性分别为34%和87%。与FNAC结合使用时,分别为4.7%和100%。该产量不足以将该技术用作选择适合进行前哨淋巴结活检的患者的常规诊断工具。

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