乳腺癌前哨淋巴结定位与活检  

Lymphatic mapping and sentinel lymph node biopsy in the patients with breast cancer

作　　者：刘锦平[1] 周毅[1] 周蕾蕾[1] 罗诚[1] 王孙庆[1] 

机构地区：[1]四川省人民医院乳腺外科,成都610071

出　　处：《医学科技》2002年第3期13-15,共3页

摘　　要：目的:验证乳腺癌前哨淋巴结定位与活检技术的可行性和前哨淋巴结能否准确预告腋淋巴结状况。方法:用美蓝(亚甲蓝)对32例乳腺癌患者进行术中及术后前哨淋巴结定位与活检。结果:26例(81.25%)检出前哨淋巴结,且均集中在 level Ⅰ区域。用美蓝定位前哨淋巴结预告腋淋巴结转移的敏感性为77%(7/9),准确性为80.76%(21/26),特异性为82.3%(14/17),假阴性率为22%(2/9)。结论:前哨淋巴结虽能预测腋淋巴结状态,但要取代腋淋巴结清扫还需进一步研究。Obejctive:To identify the feasibility of the lymphatic mapping and sentinel node biopsy (SLNB)in patients with breast cancer and to examine whether the characteristics of the sentinel lymph node(SLN)accurately predict the status of axillary node.Mothods:Lymphatie mapping was performed using methlene blue for 32 patients with breast cancer in operation and post-operation.A Slay was de- fined as any blue node.In the 32 patients,all of who underwent a complete axillary lymph node dissec- tion(ALND)following SLN biopsy.Subsequently,all SLNs and ALNs were examined by both H&E staining as well as immunohistoehemical staining for cytokeratin.Results:Lymphatic mapping was suc- cessful in identifying the SLN in 26/32(81.25%)cases involvement of nodes at level Ⅰ.Of the 26 pa- tients that mapped successfully,10 had metastasis to the SLNs.In 3 cases the SLNs were positive,but other axillary nodes were tumor negative.In 2 cases the SLNs were negative,but other axillary nodes were tumor positive.The sensitivity of SLNB using methlene blue in this study was 77%(7/9),accuracy was 80.76%(21/26),specificity was 82.3%(14/17),and false negative was 22%(2/9).Conclusion: SLN can predict the status of the axillary nodes reliably.However,the efficacy of SLNB in the setting of randomized,prospective trials must be tested first before abandoning axillary lymph node dissection as the standard of care.

关 键 词：乳腺癌 前哨淋巴结 前哨淋巴结活检 

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