Ⅰ、Ⅱ期乳腺癌前哨淋巴结活检的临床研究

目的旨在探讨用亚甲蓝法示踪和定位行乳腺癌SLNB的可行性，评估Ⅰ、Ⅱ期乳腺癌SLN对预测腋窝淋巴结转移状态的价值及其临床意义。方法对56例临床Ⅰ、Ⅱ期原发性乳腺癌患者行SLN示踪活检，术中在原发肿瘤周围注射亚甲蓝示踪定位，行SLNB和ALND，术后将SLN和所有常规ALND的淋巴结作病理检查。结果56例患者中成功检测出SLN50例，成功率为89．3％，2例出现假阴性，假阴性率为12．5％。SLNB预测腋窝淋巴结的敏感性为87．5％，特异性为100％，准确性为96％，阳性预测符合率100％，阴性预测符合率94．7％。结论应用亚甲蓝示踪定位SLNB，能准确地反映Ⅰ、Ⅱ期乳腺癌患者的腋窝淋巴结状况。

Clinical study of sentinel lymph node biopsy in patients with stage I、II breast cancer

ObjectiveThis study aimed to evaluate the reliability and accuracy of SLNB for stage I,II breast cancer.Methods56 patients with primary breast cancer,clinically TNM stage I and II included in this study.Mapping procedures and SLNB were performed using methylene blue injected at the site of the primary breast cancer,followed by the axillaries lymph node dissection.All of the SLN and ALN were examined pathologically(HE) after the operation.ResultsSLN were successfully detected in 50 of 56 patients(89.3%).The two cases of false negative were found in the group.The false negative rate was 12.5% without any false positive cases.The sensitivity,specificity and accuracy rates of SLN to predict axillaries lymph node status were 87.5%,100% and 96%,respectively.Both overall positive and negative predicative values were 100% and 97.7%.ConclusionOur study indicates that intraoprative lymphatic mapping using methylene blue and SLN can accurately predict the axillaries lymph node status of the early stage breast cancer.