乳腺癌前哨淋巴结活检术前临床可疑腋淋巴结超声引导针吸细胞学检测的临床意义  

Role of Ultrasound-Guided Fine-Needle Aspiration Cytology in Axillary Staging of Breast Cancer Patients

作　　者：孙晓[1] 李太玉[1] 王永胜[1] 陆作为[1] 仲伟霞[1] 周正波[1] 

机构地区：[1]山东省肿瘤医院乳腺病中心,济南市250117

出　　处：《中国肿瘤临床》2010年第24期1479-1482,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:评估腋淋巴结可疑阳性的乳腺癌患者,在前哨淋巴结活检术前行超声引导腋淋巴结针吸细胞学检测的临床意义。方法:回顾性分析了257例超声提示腋淋巴结异常或腋淋巴结临床查体可触及的原发性乳腺癌患者的腋淋巴结针吸细胞学检测结果及常规病理结果。结果:超声引导腋淋巴结针吸细胞学检测乳腺癌可疑腋淋巴结的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为76.3%、100%、80.9%、100%和50.5%。76.3%的患者通过针吸细胞学检测准确地预测了腋淋巴结转移,避免了接受前哨淋巴结活检术。50.5%的超声提示腋淋巴结异常但针吸细胞学阴性的患者可接受前哨淋巴结活检术替代腋淋巴结清扫术。结论:超声引导腋淋巴结穿刺针吸细胞学检测可快速、较为准确地判定乳腺癌患者腋淋巴结的状况,应该作为前哨淋巴结活检术前的筛查手段。Objective： To evaluate the utility of ultrasound-guided fine-needle aspiration cytology before sentinel lymph node biopsy in breast cancer patients with clinically abnormal axillary lymph nodes. Methods： The final pathology and ultrasound-guided fine-needle aspiration cytology results of 257 primary breast cancer patients with abnormal ultrasonographic axillary lymph nodes or palpable axillary lymph nodes seen in our hospital between October 2004 to October 2010 were retrospectively analyzed. The enrolled patients had an ultrasound-guided fine-needle aspiration cytology examination before surgery or neo-adjuvant chemotherapy. If the cytology showed a positive result, axillary lymph node dissection or neo-adjuvant chemotherapy was performed. Otherwise, sentinel lymph node biopsy was performed. Results： Considering the final pathology, the ultrasound-guided fine-needle aspiration cytology had sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 76.3%, 100%, 80.9%, 100% and 50.5%, respectively. Axillary lymph node metastases were accurately diagnosed with ultrasound-guided fine-needle aspiration cytology in 76.3% （158/207） of the patients, and sentinel lymph node biopsy was avoided in these patients. Of patients with clinically abnormal axillary lymph nodes and negative ultrasound-guided fine-needle aspiration cytology, 50.5% （50/99） had no metastases in axillary lymph nodes, and axillary lymph node dissection could be avoided with sentinel lymph node biopsy. The sensitivity of the ultrasound-guided fine-needle aspiration cytology for patients with N,, N2 and N3 node stage were 70.3%, 93.6% and 100%, respectively. The sensitivity of the ultrasound-guided fine-needle aspiration cytology for patients with T1, T2, T3 and T4 tumor size were 66.7%, 73.2%, 91.7% and 100%, respectively. Conclusion： Preoperative ultrasound-guided fine-needle aspiration cytology is a simple, minimally invasive, and reliable technique for the initial evaluation of axillary lymph node s

关 键 词：乳腺癌 前哨淋巴结活检术 细针穿刺 

分 类 号：R737.9[医药卫生—肿瘤]