前哨淋巴结活检对预测早期乳腺癌腋窝淋巴结状态的价值

目的研究前哨淋巴结活检术（sentinel lymph node biopsy,SLNB）对判断早期乳腺癌腋窝淋巴结状态应用的可行性及其预测的准确性。方法本组选择临床检测腋窝淋巴结阴性的原发性早期乳腺癌患者76例,按癌瘤长径分组,用术中在原发肿瘤周围注射亚甲蓝（美蓝）的方法定位腋窝前哨淋巴结并对其进行活检,随后行腋窝淋巴结清扫（axillary lymphnode dissection,ALND）。术后对全部淋巴结行连续切片病理检查。结果76例患者有69例检测到前哨淋巴结,成功率90.79%.69例检测到的前哨淋巴结中65例准确地判断了腋窝淋巴结转移状态,SLN预测腋窝淋巴结状态的假阳性率、假阴性率、敏感性、准确性分别为0,12.50%,87.50%,94.20%.结论SLNB基本能准确地判断早期乳腺癌腋窝淋巴结状态,故能指导cN0期乳腺癌腋窝淋巴结清扫范围。

A Study of the Sentinel Lymph Node Biopsy's Value for Predicting the Status of Axillary Nodes in Early Breast Cancer

Objective To evaluate the feasibility and accuracy of SLNB for predicting the status of axillary lymph node in breast cancer.Methods Seventy-six patients with primary early breast cancer of clinical negative axillae were studied,which were divided into three groups(T1,T2,T3)according to tumor's long diameter.SLN were localized by injecting methylene blue at the site of primary breast cancer then were biopsied,after that followed by axillary lymph node dissection(ALND).All of the axillary lymph nodes were valuated pathologically after operation.Results SLN were identified in 69 of 76 cases(90.79%) and axillary nodal status were accurately predicted in 65 of 69 cases(94.20%),the overall false-positive rate was 0,the overall false-negative rate of SLNB was 12.50%,the sensitivity of SLNB was 87.50%.Conclusion SLNB generally can accurately predict the axillary lymph metastasis of primary early breast cancer with clinical negative axillae.SLNB is useful to determine the extent of axillary dissection in cN0 breast cancer patients.