乳腺癌前哨淋巴结活检乳晕下、皮内染料注射法对比  

Subareolar injection of methylene blue versus intradermal injection for sentinel lymph node mapping and biopsy in breast cancer

作　　者：秦长岭[1] 李汉贤[1] 赵晓春[1] 欧阳军[1] 曾郁[1] 

机构地区：[1]南华大学第一附属医院肿瘤外科,湖南衡阳421001

出　　处：《中国实用医刊》2008年第2期15-17,共3页Chinese Journal of Practical Medicine

摘　　要：目的比较美蓝乳晕下（SA）注射法与皮内（ID）注射法行乳腺癌前哨淋巴结活检（SLNB）的检出率、灵敏度。方法将62例T1、T2期乳腺癌患者按注射部位不同以1：1随机分为SA组和ID组。硬膜外麻醉后，取1％美蓝（MB）5ml注入乳晕四周皮下或肿瘤上方对应皮肤周围，注射后10min取腋窝切口，切开腋筋膜解剖腋窝，循蓝染淋巴管寻找蓝染淋巴结（即SLN），行SLNB，然后实施腋窝淋巴结清扫（ALND）。所有标本送病检。结果SA组SLNB检出率为87．1％（27／31），灵敏度为85．7％（6／7），准确率为96．3％（26／27），假阴性率为14．3％（1／7）。ID组SLNB检出率为93．5％（29／31），灵敏度为87．5％（7／8），准确度为96．6％（28／29），假阴性率为12．5％（1／8）。两组间差异无统计学意义（P〉0．05）。结论采用ID法行乳腺癌SLNB的准确率和灵敏度与SA法相当，但尚需要大样本随机研究做进一步证实。Objective To compare the accuracy and success rate of two techniques, intradermal injection of methylene blue versus subareolar injection in sentinel lymph node localization in the management of early breast cancer. Methods Sixty -two patients with clinical stage T1 -T2, No breast cancer who were eligible for the study were randomized in a 1 ： 1 manner to one of two injection routes for methylene blue （MB） ： ID, SA. Immediately after the induction of epidural anesthesia, patients were injected with 5 ml of 1% MB in the SA location or the skin overlying the tumor. Then 10 minutes later,the blue SLNs were identified by searching for the blue lymphatic vessel and the blue lymph node via a small axillary incision, followed by sentinel lymph node biopsy and axillary dissection. All removed nodes were sent for pathological examination, with the sentinel node tagged separately from other nodes. Results The sentinel lymph node was identified in 27/31 （87. 1% ） SA and 29/31 （93.5%） ID （ overall P = 0. 668）. SLNB accuracy, sensitivity, false - negative rate were 96. 3% （26/27） ,85.7% （6/7） ,14. 3% （1/7） ,87.5% （7/8） ,96. 6% （28/29） ,12. 5% （1/8） for SA and ID,respeetively. Conclusion Sentinel lymph node localization by injeeton of methylene blue subareolarly or intradermally predicts the axillary lymph node status in early breast cancer with comparable success rates, accuracy. A larger randomized trial is needed to confirm these findings.

关 键 词：乳腺癌 前哨淋巴结 注射法 

分 类 号：R737.9[医药卫生—肿瘤] R452[医药卫生—临床医学]