根据美国癌症联合委员会（AJCC）第8版指南，建议对Breslow厚度至少1毫米的原发性黑色素瘤进行SLN活检。此外，国家综合癌症网络（NCCN）建议，对于T1b病变的黑色素瘤患者，可以考虑进行SLN活检，病变厚度为0.8-1毫米或小于0.8毫米并有溃疡。对于厚度小于 0.8 毫米但具有其他不良特征（例如高有丝分裂率、淋巴管侵犯或深切缘阳性）的 T1a 病灶，也可考虑进行该治疗。为了降低黑色素瘤前哨淋巴结活检的假阴性率，我们引入了伽玛相机Sentilla的术中使用，以提高前哨淋巴结的识别率，超越传统伽玛手持式探头。加州太平洋医疗中心的黑色素瘤研究和治疗中心已经建立了一种多学科方法，用于在转诊至我们的黑色素瘤中心诊断原发性黑色素瘤时治疗黑色素瘤患者。黑色素瘤肿瘤委员会的这种综合方法，包括病理学家、放射科医生、皮肤科医生、外科、内科和放射肿瘤学家的努力，达成了共识，为我们的黑色素瘤患者提供个性化和高质量的护理。这种治疗黑色素瘤的多学科计划可以重复用于其他类型的癌症。本文包含当前知识，记录已发表的前哨淋巴结识别方法。此外，我们在本文中纳入了黑色素瘤中心开发的新数据作为新发表的材料，以证明这些方法在黑色素瘤前哨淋巴结手术中的实用性。我们的 IRB 已就本研究中提供的临床数据的获取放弃知情同意书。

According to the American Joint Commission on Cancer (AJCC) 8th edition guidelines, SLN biopsy is recommended for primary melanomas with a Breslow thickness of at least 1 mm. Additionally, the National Comprehensive Cancer Network (NCCN) recommends that a SLN biopsy may be considered for melanoma patients with T1b lesions, which are 0.8-1 mm thick or less than 0.8 mm thick with ulceration. It can also be considered for T1a lesions that are less than 0.8 mm thick but have other adverse features, such as a high mitotic rate, lymphovascular invasion, or a positive deep margin. To reduce the false negative rate of melanoma SLN biopsy, we have introduced the intraoperative use of Sentinella, a gamma camera, to enhance the identification rate of SLNs beyond that of the traditional gamma hand-held probe. At the Center for Melanoma Research and Treatment at the California Pacific Medical Center, a multidisciplinary approach has been established to treat melanoma patients when the diagnosis of primary melanoma is made with a referral to our melanoma center. This comprehensive approach at the melanoma tumor board, including the efforts of pathologists, radiologists, dermatologists, surgical, medical and radiation oncologists, results in a consensus to deliver personalized and high-quality care for our melanoma patients. This multidisciplinary program for the management of melanoma can be duplicated for other types of cancer. This article consists of current knowledge to document the published methods of identification of sentinel lymph nodes. In addition, we have included new data as developed in our melanoma center as newly published materials in this article to demonstrate the utility of these methods in melanoma sentinel lymph node surgery. Informed consent has been waived by our IRB regarding the acquisition of clinical data as presented in this study.