前哨淋巴结对乳腺癌腋淋巴结状态预测价值的临床研究  

The value of sentinel lymph node in predicting the axiilary lymph node metastasis in breast caner

作　　者：韩晓蓉[1] 李黎[1] 张晨芳[1] 刘颖[1] 

机构地区：[1]广州军区总医院普外科,广东广州510010

出　　处：《中国医师杂志》2007年第3期302-304,共3页Journal of Chinese Physician

摘　　要：目的探讨前哨淋巴结对乳腺癌腋淋巴结状态的预测价值。方法选择不同分期乳腺癌患者共171例，于乳晕周围多点注射亚甲蓝2ml，6min后先行前哨淋巴结活检，随后行改良根治术。检出的SLN及非SLN分别行病理学检查。结果SLN总的检出成功率为91．2％，总的准确性为95．5％，灵敏度为92．3％，特异性为100％，假阴性率为8．8％，阳性预测值为100％，阴性预测值为87．3％。其中Ⅰ期乳癌SLN的检出成功率、准确性及假阴性率与Ⅱ期及Ⅲ期相比较差异有统计学意义。结论肿瘤的分期、淋巴管示踪成功、示踪剂的注射部位以及学习曲线直接影响前哨淋巴结的检出成功率及假阴性率。前哨淋巴结能准确地预测Ⅰ期乳腺癌的腋淋巴结状态。Objective To explore the value of sentinel lymph node in predicting the axillary lymph node metastasis in breast cancer. Methods Methelene blue 2ml was subcutaneously injected at multi-sites around the areola of mamma in 171 patients of breast cancer of different stages. All patients underwent sentinel lymph node biopsy about 6minutes after injection followed by modified radical operation. Pathohistological examination was assessed in all SLN and non-SLN patients. Results The successful detection rate of SLN was 91.22%, the accuracy of predicting ALN metastasis was 95.5%, the sensitivity was 92. 3%, the specificity was 100%, and the false negative rate was 8. 8%. The predictive value of a positive test and a negative test was respectively 100% and 87. 3%. In patients of stage Ⅰ, the successful detection rate of SLN, the accuracy of predicting ALN metastasis and the false negative rate had significant difference compared with the patients of stage Ⅱ and stage Ⅲ. Conclusions The successful detection rate of SLN and the false negative rate was influenced by the stage of tumor, the successful lymphangial trace, the injection site and so-called study curve. Sentinel lymph node can predict the axillary lymph node metastasis in stsge Ⅰ breast cancer.

关 键 词：乳腺肿瘤 淋巴结 淋巴转移 

分 类 号：R737[医药卫生—肿瘤]