29例乳腺癌内乳前哨淋巴结的临床研究  

Clinical research of internal mammary sentinel lymph node in 29 cases of breast cancer

作　　者：崔乐[1] 方金鸣[1] 易继林[2] 

机构地区：[1]武汉市普爱医院普外科,武汉430033 [2]华中科技大学同济医学院附属同济医院普外科,武汉430030

出　　处：《中国肿瘤临床与康复》2011年第3期202-205,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：武汉市卫生局2007年度临床医学科研项目;武卫[2007]43号

摘　　要：目的探讨内乳前哨淋巴结的意义及其在临床上的应用价值。方法对我院29例符合内乳淋巴结转移高危因素的患者,经蓝染示踪后,行内乳淋巴结清除,在内乳区标本中确认蓝染的前哨淋巴结。结果 29例患者共检出内乳区蓝染前哨淋巴结22例。最终病理显示,内乳淋巴结有转移者12例,其中8例为蓝染的内乳区前哨淋巴结有转移且内乳淋巴结有转移;2例为仅蓝染的内乳区前哨淋巴结有转移。1例为蓝染前哨淋巴结无转移而内乳淋巴结有转移。另1例为未检出蓝染的内乳区淋巴结者,其内乳区淋巴结有转移。后2例判定为假阴性。检出率为75.9%,灵敏度为83.3%,特异度为100%,假阴性率为16.7%,准确率为93.1%,阳性预测值100%,阴性预测值89.5%。结论内乳前哨淋巴结可以反映内乳淋巴结的转移状况,内乳前哨淋巴结的检测可以为内乳淋巴结清除提供依据。Objective To explore the significance and clinical application value of internal mammary sentinel lymph node in breast cancer surgery.Methods Twenty-nine patients with high risk factors for internal mammary lymph node metastasis were recruited into the study.Methylthionium dye was injected into the peritumor region and internal mammary lymph nodes were removed for pathological diagnosis.Results Blue stained internal mammary sentinel lymph nodes were found in 22 out of 29 patients.Pathological studied conformed that 12 out of 22 were positive,including 8 cases whose tumor had metastasized onto both blue dyed internal mammary sentinel lymph node and other internal mammary lymph nodes,2 cases metastasized onto only blue dyed internal mammary sentinel lymph node,1 case metastasized onto other internal mammary lymph nodes without blue dyed sentinel lymph node,and 1 case metastasized onto other internal mammary lymph nodes but the internal mammary sentinel lymph node not blue dyed.The latter 2 cases were judged as a false negative.The detection rate is 75.9%.Sensitivity is 83.3%.Specificity is 100%.False negative rate is 16.7%.Accurate rate is 93.1%.Positive predictive value is 100%.Negative predictive value is 89.5%.Conclusion The state of internal mammary sentinel lymph node can reflect whether the internal mammary lymph nodes were involved or not.The pathology results of internal mammary sentinel lymph node can provide a evidence for internal mammary lymph node dissection.

关 键 词：乳腺肿瘤 内乳淋巴结 前哨淋巴结 亚甲蓝 

分 类 号：R737.9[医药卫生—肿瘤] R730.45[医药卫生—临床医学]