| 现场快速评估技术在乳腺癌前哨淋巴活检术中的应用价值研究 |
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| 引用本文： | 汤琦,李惠,晋萍,张祥武,唐一吟,周绍强,陈德滇.现场快速评估技术在乳腺癌前哨淋巴活检术中的应用价值研究[J].中国肿瘤临床,2022,49(22):1161-1165. |
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| 作者姓名： | 汤琦 李惠 晋萍 张祥武 唐一吟 周绍强 陈德滇 |
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| 作者单位： | 1.云南省肿瘤医院(昆明医科大学第三附属医院)乳腺二科（昆明市650118） |
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| 基金项目： | 本文课题受云南省高层次卫计人才项目（编号:H2017040）和昆明医科大学研究生创新基金项目（编号:2021S072）资助 |
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| 摘 要： | 目的 探讨现场快速评估(rapid on-site evaluation，ROSE)技术在乳腺癌前哨淋巴结活检术（sentinel lymph node biopsy，SLNB)中的应用准确性及临床价值。 方法 纳入2019年12月至2021年12月于云南省肿瘤医院确诊的早期乳腺癌患者375例，分为行SLNB组195例（A组）、新辅助化疗后行SLNB组180例（B组），术中应用ROSE技术联合冰冻对A组444枚和B组479枚的前哨淋巴结进行快速诊断。以术后石蜡病理检查为金标准，同时再行细胞学巴氏染色及H&E染色对诊断结果进行比较，绘制各检测方法受试者工作特征( receiver operating characteristic，ROC) 曲线，计算ROC 曲线下面积( area under curve，AUC)并行McNemar 检验，评估ROSE技术的诊断效率、准确度、敏感度及特异度。 结果 ROSE技术平均诊断时间为6.53 min /例。A组和B组的ROSE技术的 AUC值分别为0.929和0.961、敏感度分别为82.35%和93.81%、特异度分别为97.56%和98.43%，A、B组与其他常规检测诊断方法比较，差异均无统计学意义（P=0.180、P=1.000）。 结论 ROSE技术联合冰冻用于乳腺癌SLNB能有效提高诊断效率，具有良好的临床应用及推广价值。
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| 关 键 词： | 现场快速评估技术 乳腺癌 前哨淋巴结活检术 |
| 收稿时间： | 2022-05-09 |
Application value of rapid on-site evaluation in sentinel lymph node biopsy of breast cancer |
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| Affiliation: | 1.2nd Department of Breast Surgery2.Department of Pathology, Yunnan Tumor Hospital/The Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China |
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| Abstract: | Objective To investigate the accuracy and clinical value of rapid on-site evaluation (ROSE) in sentinel lymph node biopsy (SLNB) of breast cancer. Methods Three-hundred and seventy-five patients diagnosed with breast cancer at Yunnan Tumor Hospital from December 2019 to December 2021 were enrolled. One-hundred and ninety-five patients (group A) diagnosed with early breast cancer underwent SLNB alone, and 180 patients (group B) with locally advanced breast cancer underwent SLNB after neoadjuvant therapy. ROSE was used intraoperatively for rapid evaluation and diagnosis of 444 and 479 SLNs in group A and B, respectively. Paraffin was used as the gold standard to compare the diagnostic results. Meanwhile, intraoperative Papanikolaou (PAP) and hematoxylin and eosin (H & E) staining results between the two groups were compared to evaluate the diagnostic accuracy, sensitivity, and specificity of ROSE by McNemar test. The receiver operating characteristic (ROC) curve of each detection method was drawn, and the area under the ROC curve (AUC) was calculated. Results The average diagnosis time of ROSE was 6.53 min/case. The AUC of group A in ROSE was 0.929, with 82.35% sensitivity and 97.56% specificity. The AUC of group B in ROSE was 0.961, with 93.81% sensitivity and 98.43% specificity. The diagnostic results of ROSE showed no statistical differences on using other detection methods（P=0.180, P=1.000). Conclusions ROSE can improve the diagnostic efficiency while reducing the diagnostic cost of SLNB for breast cancer. Moreover, apart from having good clinical application and popularization value, it is expected to become a new method for intraoperative SLNB assessment. |
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