哨兵淋巴结活检在判断乳腺癌腋窝淋巴结转移中的临床意义

目的：研究哨兵淋巴结（sentinel lymph node,SLN)活检术（SLNbiopsy,SLNB)在判断乳腺癌腋窝淋巴结转移中的可行性及准确性，以指导cN0期乳腺癌淋巴结清扫范围。方法：本组选择临床检测腋窝淋巴结阴性的原发性乳腺癌患者64例，术中在原发肿瘤周围注射美蓝进行腋窝前哨淋巴结定位及前哨淋巴结活检，随后行腋窝淋巴结清扫（axillary lymph node dissection,ALND)。术后对全部淋巴结行常规病理检查。结果：64例患者有53例检测到前哨淋巴结，成功率82.8%，53例检测到前哨淋巴结中49例准确地判断了腋窝淋巴结转移状况（92.5%)。假阴性率13.8%，敏感性86.2%，特异性100%，阳性预测值100%，阴性预测值85.7%。结论：SLNB基本能准确地判断乳腺癌腋窝淋巴结转移状况。故能指导cN0期乳腺癌腋窝淋巴结清扫范围。

Clinical significance of sentinel lymph node biopsy for predicting the metastasis of axillary lymph node in breast cancer

Objective:To evaluate the feasibility and accuracy of SLNB for predicting the metastasis of axillary lymph node in breast cancer and determining the extent of axillary dissection for cN 0 breast cancer patients.Methods:64 patients with primary breast cancer of clinical negative axillae were studied,SLNB were performed using methylene blue injected at the site of primary breast cancer followed by axillary lymph node dissection (ALND).All of the axillary lymph nodes were evaluated pathologically after operation.Results:SLN were identified in 53 of 64 cases (82.8%) and axillary nodal status were accurately predicted in 49 of 53 cases (92.5%),the overall false-negative rate of SLNB was 13.8%,the sensitivity of SLNB was 86.2%,the specificity of the SLNB was 100%.It had 100% positive predictability and 85.7% negative predictability of lymph node metastasis.Conclusions:SLNB generally can accurately predict the axillary lymph metastasis of primary breast cancer with clinical negative axillae.SLNB is useful to determine the extent of axillary dissection in cN 0 breast cancer patients.