前哨淋巴结冰冻切片检查在乳腺癌手术中的应用价值  

Application value of frozen sections of sentinel lymph node biopsy during breast cancersurgery

作　　者：叶春梅[1] 高丹[1] 黄自明[1] 陈波[1] 胡俊波[2] 薛明兴[1] 

机构地区：[1]湖北省妇幼保健院乳腺外科,武汉430070 [2]湖北省妇幼保健院病理科,武汉430070

出　　处：《临床外科杂志》2015年第10期763-765,共3页Journal of Clinical Surgery

基　　金：湖北省自然科学基金资助项目(2013CFB047)

摘　　要：目的探讨前哨淋巴结（SLN）术中冰冻切片检查在乳腺癌手术治疗中的应用价值。方法对30例腋窝淋巴结临床检查阴性的乳腺癌患者在行乳腺癌根治性手术前用1％亚甲蓝2ml示踪并成功检出SLN，术中确定并单独活检SLN，所有的SLN均行术中冰冻切片，同时术后对SLN常规石蜡切片检查，对于冰冻切片阴性SLN同时连续切片检查，从而评估冰冻切片检查SLN转移的敏感性和特异性。石蜡切片检查结果为诊断SLN转移的金标准，连续切片结果为诊断SLN微转移的金标准。结果30例患者冰冻切片SLN的阳性率为20％（6／30），石蜡切片SLN的阳性率为20％（6／30），连续切片后SLN结阳性率为33．33％（10／30）。冰冻切片检查对SLN转移诊断的敏感性和特异性均为100％；对宏转移和微转移诊断的总敏感性和特异性为60％和100％。结论冰冻切片检查对诊断乳腺癌SLN是否转移特异性较高，是一种较为可靠而快速的方法。Objective To investigate the applicationvalue of sentinel lymph node （SLN）frozen section in breast surgery. MethodsThirty breast cancer patients underwent sentinel lymph node biopsy（ SL- NB）by the intradermal injectionof 2 ml of 1% methylene blue. The intraoperatively resected SLNs were examined by frozen section. Paraffin sectioning was regularly examined postoperatively. Serial sections were done with negative SLNs in regular pathological examination to evaluate the sensitivity and specificity of the metastasis of SLNs. The postoperative paraffin section and serial section were regarded as the gold standardsin determining the macrometastasis and mierometastasis, respectively. Results The positive rate of frozen section and paraffin sectionwas 20% （6/30）. For the serial section, the positive rate was 33.33% （10/30）. The sensitivity and accuracy of frozen sectionwere 100%. The sensitivity and accuracy of macrometastasis and micrometastasis were 60% and 100%. Conclusion Frozen section is a reliable method in assessing the metastasis of SLN in breast cancer.

关 键 词：乳腺肿瘤 前哨淋巴结 冰冻切片 病理诊断 

分 类 号：R737.9[医药卫生—肿瘤]