亚甲蓝示踪法在乳腺癌前哨淋巴结活检中的临床应用  

Clinical Application of Methylene Blue Dye in Sentinel Lymph Node Biopsy for Breast Cancer

作　　者：覃俊仕[1] 罗汉传[1] 吴瑞正[1] 滕奔宇[1] 吴志懂[1] 

机构地区：[1]贵港市人民医院肝胆腺体外科,广西贵港537100

出　　处：《肿瘤药学》2012年第6期456-459,共4页Anti-Tumor Pharmacy

摘　　要：目的探讨亚甲蓝(MB)示踪法在乳腺癌前哨淋巴结活检(SLNB)中的临床应用价值。方法选择临床T1-2N0-1M0乳腺癌患者96例,用MB示踪法进行SLNB,而后行腋窝淋巴结清扫术(ALND)。前哨淋巴结(SLN)行冰冻切片病理,术后SLN及非前哨淋巴结(nSLN)均行HE染色进行病理观察。结果 SLN检出率96.9%(93/96)。93例SLN冰冻切片阳性54例,阴性39例。HE染色SLN阳性56例,阴性37例,nSLN阳性22例,其中20例SLN同时阳性,2例阴性,即SLN假阴性2例。SLN冰冻切片与HE染色病理诊断的符合率为97.9%(91/93)。按照HE染色病理检查计算,SLN预测腋窝淋巴结(ALN)状态的假阴性率3.5%(2/58),敏感度96.6%(56/58),准确性97.9%(91/93),阳性预测值100%(56/56),阴性预测值94.6%(35/37)。结论单用MB示踪法行乳腺癌SLNB的检出率及敏感性较高,且经济实用,适宜在广大基层医院推广应用。Objective To analyze the clinical value and indications of trace inethod of methylene blue dye （MB） alone in sentinel lymph node biopsy （SINB） of breast cancer. Methods 96 cases of clinical T1-2Na-1Mo breast cancer were enrolled in this study. MB method was used for SLNB, and axillary lymph node dissection（ALNl）） was performed after SLNB. All sentinel lymph nodes （SLNs） were examined pathologically with frozen section. All SLNs and non--sentinel lymph nodes （nSLNs） were examined pathologically with HE staining after operation. Results The identification rate of SLNs was 96.9% （93/96）. In the frozen section of 93 SINs, 54 cases were positive, and 39 cases were negative. By thc HE staining, 56 cases of SLNs were positive, and 37 cases were negative; 22 nSLNs werc positive, in which 20 SLNs were also positive and 2 cases were negative, that is, 2 SLNs were fals-negativc. The coincidcnce rate of SLN pathologically diagnosis by frozen section and HE staining was 97.9% （91/93）. According to the HE staining pathologically, the false negative rate was 3.5% （2/58）, the sensitivity was 96.6% （56/58）, the accuracy was 97.9% （91/93）, the positive predictive value was 100% （56/56）, and the negative predictive value was 94.6% （35/37）. Conclusion There is high identifica- tion rate and sensitivity by using tracing lnethod of MB alone in SLNB of breast cancer. It is an economical and practical method, which is worth being popularized in grassroots hospitals.

关 键 词：乳腺癌 前哨淋巴结活检 亚甲蓝 临床价值 

分 类 号：R736[医药卫生—肿瘤]