乳腺癌术前肿物切除活检对亚甲蓝腋窝前哨淋巴结染色成功率的影响  

Effect of preoperative tumor biopsy on success rate of methylene blue staining for axillary sentinel lymph node biopsy in breast cancer surgery

作　　者：郭向阳[1] 曲隽渊[1] 薛登峰[1] 梁帅[1] 李嘉[1] 刘慧娟 于磊[1] 赵旭晔[1] Guo Xiangyang;Qu Junyuan;Xue Dengfeng;Liang Shuai;Li Jia;Liu Huijuan;Yu Lei;Zhao Xuye(The Second Ward,Department of Breast Surgery,Shanxi Provincial Tumor Hospital,Taiyuan030013,China)

机构地区：[1]山西省肿瘤医院乳腺外科二病区,太原030013

出　　处：《中国药物与临床》2021年第6期914-916,共3页Chinese Remedies & Clinics

基　　金：山西省重点研发计划(201803D31169)。

摘　　要：目的探讨乳腺癌患者术前肿物切除活检对亚甲蓝前哨淋巴结活检(SLNB)染色成功率有无影响。方法回顾性分析2012年4月至2018年10月在山西省肿瘤医院接受SLNB的cT1~2N0M0的早期乳腺癌患者共174例,其中术前行肿物空芯针穿刺活检98例,术前行肿物切除活检76例。比较2组患者行亚甲蓝SLNB的检出率有无差异,以及分析肿物切除活检组中SLNB检出率的影响因素。结果术前空芯针穿刺活检组成功发现前哨淋巴结的有91例,染色成功率为93%,每例患者平均检出(4.2±0.9)枚,肿物切除活检组成功发现前哨淋巴结的有68例,染色成功率为89%,每例患者平均检出(3.9±1.0)枚,2组差异无统计学意义(均P>0.05)。单因素分析结果显示,患者的体质量指数、是否伴有脉管癌栓可能与乳腺肿物切除活检后的乳腺癌患者SLNB检出率有关(P=0.012,P=0.034)。结论术前肿物切除活检对乳腺癌患者行亚甲蓝SLNB检出率并无显著影响,但对于体质量指数偏大、有脉管癌栓的患者应该慎重。Objective To investigate the effect of preoperative tumor resection biopsy on the success rate of methylene blue staining for axillary sentinel lymph node biopsy(SLNB)in breast cancer surgery.Methods The clinical data of 174 patients with early breast cancer(cT1-2N0M0),who received SLNB in Shanxi Provincial Tumor Hospital between April 2012 and October 2018,were retrospectively analyzed.Ninety-eight patients underwent preoperative core needle biopsy of tumors,and 76 cases underwent preoperative tumor resection biopsy of tumors.The difference in the detection rate of SLNB through methylene blue staining was compared between the two groups.The influencing factors on the SLNB detection rate in the tumor resection biopsy group were determined.Results In the preoperative core needle biopsy group,91 cases of sentinel lymph node(SLN)were successfully detected,and the staining success rate was 93%,with an average number of 4.2±0.9 per patient.In the tumor resection biopsy group,68 cases of sentinel lymph node(SLN)were successfully detected,and the staining success rate was 89%,with an average number of 3.9±1.0 per patient.There were no statistically significant differences between the two groups(all P>0.05).Univariate analysis showed that body mass index(BMI)and presence of vascular tumor thrombus may be associated with SLNB detection rate after tumor resection and biopsy in patients with breast cancer(P=0.012,P=0.034).Conclusion There is no significant influence of preoperative tumor resection biopsy on detection rate of SLNB through methylene blue staining in breast cancer patientst,but it should be cautious for patients with large BMI and vascular tumor thrombus.

关 键 词：乳腺肿瘤 组织检查 细针 肿物切除活检 前哨淋巴结活组织检查 

分 类 号：R737.9[医药卫生—肿瘤]