早期乳腺癌前哨淋巴结活检手术中示踪方法的临床应用研究

目的对比分析核素联合亚甲蓝与亚甲蓝单示踪法在早期乳腺癌前哨淋巴结活检术中应用效果。方法收集我院385例行前哨淋巴结活检术的乳腺癌患者的临床资料,其中109例由高年资医生应用亚甲蓝单示踪法,276例由高年资和低年资两组医生应用核素联合亚甲蓝示踪法,对比分析行联合示踪法与单示踪法前哨淋巴结活检结果的差异。并分析不同年资手术医生在联合示踪法前哨淋巴结活检结果的差异。结果联合示踪法与亚甲蓝单示踪法在前哨淋巴结活检的检出率、假阴性率、准确率、灵敏率无统计学意义(P>0.05),在联合示踪法下,高年资手术医生与低年资手术医生的前哨淋巴结活检的检出率、假阴性率、准确率无显著差异(P>0.05)。结论高年资外科医生使用亚甲蓝单示踪法行前哨淋巴结活检,是安全可靠又经济的方法。联合示踪法有助于帮助年轻的乳腺外科医生快速掌握熟悉前哨淋巴结活检技术。

Clinical study of tracer method on sentinel lymph node biopsy for early breast cancer

Objective To compare and analyze the effect of radiosotope combined with methylene blue and methylene blue single tracer in sentinel lymph node biopsy of early breast cancer.Methods The clinical data of 385 breast cancer patients who underwent sentinel lymph node biopsy in our hospital were collected. Among them,109 cases were performed with methylene blue single tracer by senior doctors. And 276 cases were performed with radiosotope combined with methylene blue by senior and junior doctors. The differences of sentinel lymph node biopsy results were analyzed and compared between double tracer and single tracer,so did sentinel lymph node biopsy with double tracer between senior and junior surgeons.Results There was no significant difference in detection rate,false negative rate,accuracy rate and sensitivity between double tracer and methylene blue single tracer in sentinel lymph node biopsy(P>0.05). There was no significant difference in detection rate,false negative rate and accuracy rate between senior surgeons and junior surgeons under double tracer method(P>0.05).Conclusion It is safe,reliable and economical for senior doctors to perform sentinel lymph node biopsy with methylene blue single tracer method. The double tracer method can help junior breast doctors master sentinel lymph node biopsy quickly.