乳腺癌前哨淋巴结活检术中不同染色淋巴结与肿瘤转移的关系  

Relationship between lymph node staining and tumor metastasis in sentinel lymph node biopsy of breast cancer

作　　者：许健[1] 章远江[1] 金科[1] XU Jian;ZHANG Yuan-jiang;JIN Ke(Department of Breast and Thyroid Surgery,Changshu Second People′s Hospital,Changshu Jiangsu 215500,China)

机构地区：[1]常熟市第二人民医院乳腺甲状腺外科

出　　处：《局解手术学杂志》2020年第1期79-82,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨乳腺癌前哨淋巴结活检术(SLNB)中不同染色情况的淋巴结与肿瘤转移的关系。方法选择我院2014年1月至2018年1月行前哨淋巴结活检的乳腺癌患者92例,以亚甲蓝为示踪剂,根据92例乳腺癌患者SLNB中淋巴结染色情况的不同分为无染色组、完全染色组和染色不均组,病理检测3组患者淋巴结的肿瘤转移情况并作比较。结果92例乳腺癌SLNB共取得淋巴结256枚,平均每例患者2.8枚,无染色组(80枚)肿瘤转移率为13.8%,完全染色组(112枚)肿瘤转移率为43.8%,染色不均组(64枚)肿瘤转移率为62.5%,3组间肿瘤转移率差异有统计学意义(P<0.05)。结论乳腺癌SLNB中染色不均的淋巴结最易出现肿瘤转移,其次为完全染色的淋巴结,染色淋巴结附近看到的未染色淋巴结也有肿瘤转移的可能,宜一并切除送检,有利于降低假阴性率。Objective To investigate the relationship between lymph node staining and tumor metastasis in sentinel lymph node biopsy(SLNB)of breast cancer.Methods Totally 92 breast cancer patients with SLNB in our hospital from January 2014 to January 2018 were selected and divided into non staining group,complete staining group and inhomogeneous staining group according to the different staining state by methylene blue.The tumor metastasis of lymph nodes in three group were examined by pathological examination and compared.Results Totally 256 lymph nodes were obtained from sentinel lymph node biopsy of 92 breast cancer patients,with an average of 2.8 per case.The tumor metastasis rate of the non staining group(80 nodes)was 13.8%,the complete staining group(112 nodes)was 43.8%,and the inhomogeneous staining group(64 nodes)was 62.5%,the differencs were statistically significant(P<0.05).Conclusion The tumor metastasis rate of lymph node with different staining state in sentinel lymph node biopsy of breast cancer is not the same.The inhomogeneous staining lymph node is most likely to have tumor metastasis,followed by complete staining lymph node.The non staining lymph node around the staining lymph node may also have tumor metastasis,so it should be excised and sent for pathological examination together,which can reduce the false negative rate.

关 键 词：乳腺癌 前哨淋巴结 染色 肿瘤转移 淋巴结活检术 示踪剂 亚甲蓝 

分 类 号：R737.9[医药卫生—肿瘤]