乳腺癌前哨淋巴结活检的临床探讨  

Clinical Study of Sentinel Iymph Node Biopsy in Breast Canser

作　　者：李振平[1] 李占文[1] 胡云锵[1] 刘纯[1] 杨华峰[1] 王雯[2] 杨海涛[2] 陈冬[2] 徐亚军[2] 周尚燕[2] 

机构地区：[1]宁波市妇女儿童医院乳腺科,浙江省宁波市315012 [2]宁波市妇女儿童医院病理科,浙江省宁波市315012

出　　处：《中国肿瘤临床》2005年第12期681-683,共3页Chinese Journal of Clinical Oncology

基　　金：宁波市卫生局科研基金资助(编号:2002017)

摘　　要：目的:评估乳腺癌前哨淋巴结活检(SenitallymphnodebiopsySLNB)对预测腋窝淋巴结转移状态的价值及其临床意义。方法:临床Ⅰ、Ⅱ期原发女性乳腺癌41例,体检无腋淋巴结肿大或虽有肿大而估计非转移性。术中在原发肿瘤周围注射亚甲蓝示踪定位,行SLNB和腋淋巴结清扫(AxillarylymphnodedissectionALND)。术后对全部前哨淋巴结(SLN)和腋淋巴结(ALN)行常规病理检查。结果:41例中检出SLN者32例,检出率为78.0%。其中N0组25例准确度为96.0%;阳性预测符合率100%;假阴性0例,阴性预测符合率100%。N1组7例准确度仅57.1%,假阴性2例,阴性预测符合率0。结论:应用亚甲蓝示踪定位SLNB,能准确预测(T1、T2)N0M0乳腺癌患者的转移状态,宜于推广应用。Objective: To evaluate the accuracy and the clinical significance of the sentinel lymph node biopsy in predicting the axillary lymph node status of the breast cancer patients. Methods: In our study, there were 41 patients with primary breast cancer, clinically TNM stage Ⅰ and Ⅱ in negative axillae. Mapping procedures and SLNB were performed using methylene blue injected at the site of the primary breast cancer, followed by the axillary lymph node dissection. All of the SLN and ALN were evaluated pathologically (HE) after the operations. Results: A total of 32 in 41 cases (78.0%), SLN were identified. Of them, the group one, (T1, T2) N0M0, had the axillary nodal status accurately predicated in 24/25(96%); 0 in 22 (0%), the SLN was false-negitive, Both overall positive and negative predicative values were 100%. In the group (T1T2) N1M0, there were the axillary nodal status accurately predicated in 4 of 7 cases (57.1%); in 2 of 7 cases with the false-negative SLN. Conclusion: Our study indicates that intraoprative lymphatic mapping using methylene blue and SLN can accurately predict the axillary lymph node status of the (T1, T2) N0M0 cancer patients.

关 键 词：乳腺肿瘤 活组织检查 前哨淋巴结 

分 类 号：R737.9[医药卫生—肿瘤] R730.4[医药卫生—临床医学]