前哨淋巴结快速病检在乳腺癌根治术中的应用价值

目的探讨乳腺癌快速前哨淋巴结病检(SentinelLymphNodeBiopsy,SLNB)的可行性和准确性,认识其在乳腺癌手术中的临床应用价值。方法手术中采用1%美蓝5ml在肿瘤周边选两点注射,根据肿块距腋窝的距离,10分钟￣15分钟后取腋窝下皱折线切开,循蓝染淋巴管寻找前哨淋巴结。全组32例切除肿瘤和同侧腋窝淋巴结,其中27例SLN后行腋窝淋巴结解剖(ALND),两标本同时送病理检查,了解其符合率,并评价SLNB的可行性。结果全组32例均进行了SLNB识别定位,1例未取得SLN,故SLN的检出率为96.7%,另1例SLN病理呈假阴性。按目前国外SLNB的评价标准,本组SLNB的敏感率为88.2%,准确性96.8%,假阳性率为0,假阴性率为5.9%。结论乳腺癌SLNB目前国内、外仍处于研究阶段,随着研究的扩大与深入将可能取代常规的ALND。

Value of Sentinel Lymph Node Radical Mastectoy for Breast Cancer

Objective To study the feasibility and accuracy of sentinel lymph node biopsy (SLNB) for breast cancer, and discussed the clinical application value in breast cancer operation. Methods In this operation, 5 ml 1% methylene blue was injected into two sites around the tumor. After 10 to 15 minutes, according to the distance between tumor and axillary, we cut down the skin along the crease under axillary and searched for sentinel lymph nodes (SLN) following blue-stained lymphatic vessel. Among the 32 patients registered, 27 received axillary lymph node dissection (ALND) after SLN resection, and these two specimens were delivered to pathologic study at the same time, in order to study the coincidence rate of them and evaluate the feasibility of SLNB. Results All of 32 patients received SLNB recognization. One case didn't get SLN showed false-negative. According to SLNB evaluation criterion abroad, in this trial, sensitivity of SLNB is 88.2%, accuracy 96.8%, false-positive rate 0, false-negative 5.9%.Conclusion At present, SLNB for breast cancer is still at research phase. With expanding and deepening of the study, SLNB may replace routine ALND.