Biopsy of sentinel lymph nodes in patients with local forms of skin melanoma

Abstract

Background. Assessment of diagnostic informativeness of sentinel lymph nodes (LN) detection in primary skin melanoma (MC). Materials and methods. The results of the examination of 79 patients with MK of the trunk and extremities were analyzed; the average age was 52,9±17,4 years. Results. According to the lymphoscintigraphy, the LT sentinel was found in all patients. The sensitivity of the histological method in the determination of micrometastases MK in the sentinel lymph node (SLN) was 50%, specificity - 100%, accuracy - 88 ,3%. The low sensitivity of the method indicates the need for additional immunohistochemical studies of SLN. The diagnostic informativity of the LN biopsyin relation to the detection of MK metastases in regional LNs was: sensitivity - 87%, specificity - 100%, accuracy - 96,2%. Conclusion. SLN biopsy is a highly informative, low-impact method that allows the majority of patients to determine the stage of the disease with high accuracy and perform lymphadenectomy in the early stages with a minimum amount of metastases. Its implementation can be recommended to all patients with local forms of MK. Prior to biopsy of SLN, an indirect radionuclide lymphoscintigraphy should be performed to determine the pathways of lymphatic drainage from the primary MC, followed by static and dynamic polyposition scintigraphy to determine the topography of SLN.