ROSE技术在乳腺癌前哨淋巴结术中活检的诊断价值  

The diagnostic value of ROSE technique in the intraoperative biopsy of sentinel lymph nodes in breast cancer

作　　者：宋丽娟 包蔚郁 罗雁 何欣 康雅琼 李晓琴 BAO Weiyu;LUO Yan;HE Xin;KANG Yaqiong;LI Xiaoqin(Sun Yat-sen University Cancer Center Gansu Hospital/Gansu Provincial Cancer Hospital,Lanzhou 730050,China)

机构地区：[1]中山大学附属肿瘤医院甘肃医院/甘肃省肿瘤医院,甘肃兰州730050

出　　处：《甘肃医药》2024年第10期865-868,共4页Gansu Medical Journal

基　　金：甘肃省青年科技基金计划项目(编号:20JR5RA157)。

摘　　要：目的:探讨快速现场评估(ROSE)技术在乳腺癌前哨淋巴结(SLN)术中活检的应用价值。方法:分析2023年10月至2024年3月在甘肃省肿瘤医院接受乳腺癌SLN术中活检患者的临床病理数据。共纳入123例SLN活检患者,共467枚SLN,所有SLN均行ROSE检查和冷冻切片检查,分析ROSE诊断的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和准确率,并统计ROSE和术中冷冻技术诊断单例患者所有SLN的平均时长。结果:ROSE诊断的敏感性、特异性、PPV和NPV分别为84.2%、98.4%、82.1%、98.6%,准确率为97.2%。ROSE技术与最终石蜡病理诊断一致性好,Kappa一致性指数为0.816(P<0.001)。ROSE诊断单例患者所有SLN平均时长(4.20±1.94)min,低于术中冷冻诊断时间(25.76±4.38)min,差异有统计学意义(t=75.59,P<0.001)。结论:ROSE技术在乳腺癌SLN术中活检中诊断准确率高且用时短,与术中冷冻切片诊断和石蜡病理诊断结果一致性好,值得临床推广应用。Objective:The study was conducted to assess the diagnostic value of rapid on-site evaluation(ROSE)in intraoperative sen-tinel lymph node(SLN)biopsy for breast cancer.Methods:Clinicopathological data of 123 patients who underwent SLN biopsy at Gansu Provincial Cancer Hospital from March 2023 to March 2024 were analyzed,including a total of 467 SLNs.All SLNs underwent ROSE and frozen section examination.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of ROSE diag-nosis were evaluated,along with the average time for ROSE to diagnose all SLNs in a single patient.Results:The sensitivity,specificity,PPV and NPV of ROSE diagnosis were 84.2%,98.4%,82.1%and 98.6%,respectively,and the accuracy rate was 97.2%.ROSE technique was in good a-greement with the final pathological diagnosis of paraffin,and the Kappa consistency index was 0.816(P<0.001).The average time for ROSE(4.20±1.94)min to diagnose all SLNs in a single patient was significantly lower than the intraoperative freezing diagnosis time(25.76±4.38)min,and the difference was statistically significant(t=75.59,P<0.001).Conclusion:The results showed that the ROSE technique had high diagnostic accura-cy and shorter diagnosis time compared to intraoperative freezing diagnosis.It also demonstrated good agreement with freezing diagnosis and fi-nal Paraffin-embedded tissue diagnosis.Therefore,it is worthy recommended for clinical application.

关 键 词：快速现场评估 前哨淋巴结 术中冷冻 乳腺癌 诊断 

分 类 号：R737.9[医药卫生—肿瘤]