前哨淋巴结活检术在单侧多发乳腺癌中的可行性研究  

A feasibility study of sentinel lymph node biopsy in preoperatively diagnosed multiple unilateral synchronous breast cancers

作　　者：冯令军[1] 

机构地区：[1]潍坊医学院附属医院甲状腺乳腺外科,山东潍坊261031

出　　处：《中国现代医生》2014年第29期152-154,共3页China Modern Doctor

基　　金：山东省潍坊市科技局课题(261-2)

摘　　要：目的研究前哨淋巴结(sentinel lymph node,SLN)活检术(SLN biopsy,SLNB)对单侧多发乳腺癌(multiple synchronous tumor,MST)患者腋窝淋巴结状态判断的可行性。方法在23例确诊单侧多发乳腺癌患者术中行SLNB,所有患者均行乳腺癌改良根治术,如患者拒绝或者两病灶位于乳房同一象限,改行保乳加腋窝淋巴结清扫术(axillary lymphnode dissection,ALND)。术中不送检SLN,ALND后由手术医师分离出SLN送检。术后对全部淋巴结行连续切片病理检查。结果 23例患者有21例完成前哨淋巴结活检术,成功率91.3%。SLN预测腋窝淋巴结状态的假阴性率、敏感度、准确率分别为15.4%,84.6%,90.5%。结论 SLNB假阴性率高,不推荐在单侧多发乳腺癌患者中实行前哨淋巴结活检。Objective To evaluate the feasibility of SLNB for predicting the status of axillary lymph node and determin-ing the extent of axillary dissection in preoperatively diagnosed multiple unilateral synchronous breast cancers. Methods A total of 23 MST patients of clinical negative axillae diagnosed by core needle biopsy were studied. SLN was localized by injecting methylene blue. No intraoperative pathological examination. All patients with MST were eligible for initial breast surgery （radical modified mastectomy or conservative surgery＋ALND）. To choose radical modified mastectomy unless MST was limited to two foci in the same quadrant or patient＆#39;s opposition for total mastectomy）. Sentinel lymph nodes （SLNs） were submitted to pathological doctor after ALND. All lymph nodes were valuated pathologically after operation. Results Of 23 patients, 21 cases were assessable. The SLNB-identified rate was 91.3%. The false-negative rate（FNR）was 15.4%, the accuracy rate was 90.5%, and the sensitivity was 84.6%. Conclusion With a high FNR,we do not recommend SLNB as a routine procedure for MST.

关 键 词：单侧 多发 乳腺癌 前哨淋巴结 腋窝淋巴结清扫 

分 类 号：R737.9[医药卫生—肿瘤]