乳腺癌前哨淋巴结活检的实践与体会  

Experiences of sentinel lymph node biopsy in breast cancer

作　　者：张保宁[1] 宣立学[1] 张涛[1] 王仲照[1] 陈国际[1] 易进[1] 刘淋[2] 陈盛祖[2] 

机构地区：[1]中国医学科学院肿瘤医院乳腺疾病诊治中心,北京100021 [2]中国医学科学院肿瘤医院核医学科,北京100021

出　　处：《中华普通外科杂志》2005年第11期704-706,共3页Chinese Journal of General Surgery

基　　金：国家十五科技攻关项目(2001BA703B20)

摘　　要：目的评价乳腺癌前哨淋巴结活检(sentinel lymph node biopsy,SLNB)的可行性,并分析影响该技术成功率的相关因素。方法术前于肿瘤周围皮内分别注射放射性胶体和蓝色染料两种前哨淋巴结示踪剂,术前先行淋巴闪烁扫描,术中应用γ计数探测仪检测,并结合淋巴结蓝染情况定位SLN,切除SLN后再行腋窝淋巴结清扫(axillary lymph node dissection,ALND),两标本均行组织学检查。结果全组116例乳腺癌SLNB的检出率98.3%,该技术的灵敏度93.6%,准确性97.4%,假阴性6.4%。结论乳腺癌SLNB是一种简便、安全的检测技术,可用于了解腋窝淋巴结的状况,有望在早期乳腺癌中取代常规的ALND。Objective To evaluate the feasibility of sentinel lymph node biopsy （ SLNB ） during surgery of breast cancer, Methods Radioactive colloid and blue dye were injected intradermally around the tumor seperately before the operation and the SLN were detected first by lymph scintigraphy, SLN was detected and located using γ-finder and the blue dye. Axillary lymph node dissection（ALND） was performed routinely after the SLNB. Results Among 116 breast cancer patients, this procedure was successful in 98, 3% of cases. The sensitivity, accuracy and false negative rate were 93, 6%, 97, 4% and 6.4%, respectively, Conclusions SLNB is a simple, safe and reliable technique, Routine ALND could be raplaced by SLNB in breast cancer patients undergoing surgery.

关 键 词：乳腺肿瘤 淋巴转移 前哨淋巴结 活检 

分 类 号：R737.9[医药卫生—肿瘤] R651.1[医药卫生—临床医学]