乳晕皮下与肿瘤周围注射造影剂定位乳腺癌前哨淋巴结的效果比较  

Comparative study of injection location of sentinel lymph nodes in breast cancer with under areola and injection around the tumor

作　　者：郭坤鹏 钟扶颖 蔡振鑫[2] 政峰 GUO Kun-peng;ZHONG Fu-ying;CAI Zhen-xin(Department of General Surgery,Shanghai Electric Power Hospital,Shanghai 200050,China;Department of Breast Surgery,Fudan University Affiliated to Huashan Hospital,Shanghai 200050,China)

机构地区：[1]上海市电力医院普外科,上海200050 [2]复旦大学附属华山医院乳腺外科,上海200050

出　　处：《临床和实验医学杂志》2018年第22期2450-2453,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市卫生与计划委员会课题支持(编号:201440014)

摘　　要：目的对比乳晕皮下与肿瘤周围注射造影剂定位乳腺癌前哨淋巴结(SLN)的效果。方法回顾性选择2015年6月至2017年6月上海市电力医院普外科收治的乳腺癌患者共98例,分别采用乳晕皮下与肿瘤周围注射造影剂定位乳腺癌SLN,比较两种方法定位SLN的敏感度、特异性和准确度。结果在98例患者中,亚甲蓝染色共检出SLN181个,乳晕皮下注射法共检出SLN 162个,检出率为89. 50%;肿瘤周围注射法共检出SLN 158个,检出率为87. 29%。两者检出率比较差异无统计学意义(χ~2=0. 572,P=0. 833)。经乳晕皮下注射超声造影剂检测SLN的准确度为95. 68%(155/162),敏感度为96. 67%(145/150),特异性为83. 33%(10/12)。经肿瘤周围注射超声造影剂检测SLN的准确度为79. 75%(126/158),敏感度为82. 52%(118/143),特异性为53. 33%(8/15)。结论经乳晕皮下注射超声造影剂检测SLN,其准确度、敏感度、特异性均高于经肿瘤周围注射的方式,且其检出率高,值得在临床推广应用。Objective To analyze the effect of the injection location of sentinel lymph node （SLN） in breast cancer under areola and injection around the tumor. Methods A total of 98 patients with breast cancer were selected in Shanghai Electric Power Hospital from June 2015 to June 2017 retrospectively. Sentinel lymph nodes were detected with injection around the tumor or under areola. The sensitivity, specificity and accuracy of the two methods for localization of lymph nodes were compared. Results Among 98 patients, 181 SLNs were detected by methylene blue staining and 162 were detected by areola injection, the detection rate was 89.50%. A total of 158 SLNs were detected by injection around the tumor, with a detecfon rate of 87.29%. Tbere was no significant difference between the two detection rates （χ2 =0. 572, P=0. 833 ）. The accuracy of subcutaneous injection of ultrasound contrast agent under the areola was 95.68% （155/162） , with the sensitivity was 96.67% （145/ 150） and the specificity was 83.33% （10/12）. The accuracy of detecting SLN by subcutaneous injection of ultrasound contrast agent around the tumor was 79.75% （ 126/158 ） , with the sensitivity was 82.52% （118/143） and the specificity was 53.33% （8/15）. Conclusion The accuracy, sensitivity and specificity of SLN detected by subcutaneous injection of ultrasound contrast agent under the areola are higher than those injected around the tumor. The detection rate is high, which is worthy of clinical application.

关 键 词：乳腺癌 前哨淋巴结 定位 乳晕下注射 肿瘤周围注射 

分 类 号：R737.9[医药卫生—肿瘤]