摘要
皮肤黑色素瘤是一种高度恶性肿瘤,其早期淋巴转移直接影响患者的治疗决策与预后评估。前哨淋巴结活检作为评估区域淋巴结转移情况的关键手段,近年来在显像技术辅助下取得显著进展。核素显像技术的进步显著提升了前哨淋巴结活检的精准度。新研发的多种新型放射性示踪剂(如^(99)mTc-Tilmanocept等)表现出高特异性,有助于前哨淋巴结的精准示踪。新型核素成像技术如单光子发射计算机断层显像/计算机断层扫描提供精确的三维解剖信息,提高了前哨淋巴结的检出率,尤其适用于复杂解剖区域。而多模态成像融合(如移动伽马相机结合淋巴闪烁或近红外荧光)可增强前哨淋巴结的识别能力。新型PET靶向示踪探针(如[^(68)Ga]Ga-SPM、^(18)F-PFPN等)在前哨淋巴结活检及黑色素瘤微小病灶检测定性和定位方面展现出良好应用前景,而非核素显像技术如多光谱光声断层扫描、超顺磁性氧化铁MRI成像、增强超声等近年来也有应用突破。本文围绕核素显像与非核素显像技术在黑色素瘤前哨淋巴结活检中的研究进展进行综述,为临床医生和科研人员提供参考。
Cutaneous melanoma is a highly malignant tumor,and early lymphatic metastasis significantly influences treatment decisions and prognostic evaluation.Sentinel lymph node biopsy,as a crucial technique for assessing regional lymph node involvement,has made remarkable progress in recent years with the support of advanced imaging technologies.Developments in radionuclide imaging have notably improved the accuracy of SLNB.Several novel radiotracers,such as ^(99) mTc-Tilmanocept,have demonstrated high specificity and facilitate precise localization of sentinel lymph nodes.Advanced imaging modalities,including single-photon emission computed tomography/computed tomography,offer accurate three-dimensional anatomical information and significantly enhance detection rates,particularly in anatomically complex regions.In addition,multimodal imaging approaches,such as portable gamma cameras combined with lymphoscintigraphy or near-infrared fluorescence,further improve intraoperative node identification.Emerging tracers,including[^(68) Ga]Ga-SPM and ^(18) F-PFPN,show promising potential in the localization and characterization of sentinel nodes and microscopic melanoma metastases.On the other hand,non-nuclear imaging techniques,such as multispectral optoacoustic tomography,superparamagnetic iron oxide enhanced magnetic resonance imaging,and contrast-enhanced ultrasound,have also demonstrated notable advances.This review summarizes recent progress in both nuclear and non-nuclear imaging technologies for sentinel lymph node biopsy in cutaneous melanoma,offering valuable insights for both clinicians and researchers.
作者
邱泽群
邵国强
王焱
QIU Zequn;SHAO Guoqiang;WANG Yan(Hospital for Skin Diseases,Institute of Dermatology,Chinese Academy of Medical Sciences&Peking Union Medical College,Nanjing 210042,China;Nanjing Hospital,Nanjing Medical University,Nanjing 210000,China)
出处
《皮肤性病诊疗学杂志》
2025年第7期485-491,共7页
Journal of Diagnosis and Therapy on Dermato-venereology
基金
国家自然科学基金(81872216)
国家重点研究与发展计划(2022YFC2504700,2022YFC2504701,2022YFC2504705)
江苏省卫生健康委医学科研立项项目(M2024012)
CAMS医学科学创新基金(2024-I2M-C&T-B-089)。
