非节点区域转移在预测皮肤黑色素瘤中哨戒淋巴结状态中的预测价值:哨戒淋巴结工作组数据库的多中心分析
Nazia Riaz1,2, Stanley P Leong3, Mohammed Kashani-Sabet3
1Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. nazia.riaz@gu.se.
Annals of surgical oncology
|January 23, 2026
概括
皮肤黑色素瘤的非节点区域转移与侵袭性疾病和较差的生存结果有关. 即使在阴性哨兵淋巴结 (SLN) 状态下,这些转移也表明预后不佳,这凸显了SLN评估对风险分层的重要性.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 手术病理学手术病理学
背景情况:
- 非节点区域转移 (微卫星病变,卫星,过境转移) 是皮肤黑色素瘤的一种不常见但积极的表现.
- 这些转移模式与不良的临床病理特征有关,并影响患者的预后.
研究的目的:
- 评估皮肤黑色素瘤非节点区域转移和临床病理特征之间的关联.
- 评估与哨兵淋巴结 (SLN) 状态和患者整体结果相关的非节点区域转移的预后意义.
主要方法:
- 利用了哨兵淋巴结工作组 (SLNWG) 数据库,分析了13,474名患者的数据.
- 采用多变量逻辑回归和考克斯回归模型来检查关联和预后影响.
- 具体分析了SLN状态为负的患者的结局.
主要成果:
- 在3.4%的患者中发现了非节点区域转移,并与不良特征和较高的SLN阳性概率 (OR2.75) 相关.
- 这些转移与更差的无复发存活率 (RFS),黑色素瘤特异性存活率 (MSS) 和整体存活率 (OS) 有显著的相关性.
- 即使在SLN阴性亚组中,不良预后关联也持续存在,RFS,MSS和OS明显恶化.
结论:
- 非节点区域转移是SLN参与和皮肤黑色素瘤不良预后的独立预测因素.
- 即使SLN是负的,患者的治疗结果仍然很差,这强调了非节点转移的预后相关性.
- 临床结节阴性患者的SLN评估对于临床结节阴性患者的风险分层至关重要,这些患者呈现非结节区域转移.
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