亚甲蓝法在乳腺癌前哨淋巴结活检中的应用

目的:探讨亚甲篮作为示踪法进行前哨淋巴结活检在乳腺癌治疗中的应用价值。方法:对已确诊的172例临床腋窝淋巴结阴性的乳腺癌患者术中亚甲蓝乳晕周围皮下注射后行腋窝前哨淋巴结切除,送冰冻病理检查,再行乳腺癌改良根治术,并常规腋窝淋巴结清扫,术后病理石蜡切片检查前哨淋巴结及手术切除标本。结果:167例(97.1%)成功实施SLNB,5例(2.9%)术中未能发现SLN,立即改行腋窝淋巴结清扫术(ALND)。行SLNB的167例中,术中冰冻报告SLN癌转移21例,即行ALND;146例冰冻检查SLN未见癌转移。5例术后HE染色检查发现SLN存在1枚微转移淋巴结,4例接受ALND,1例拒绝行腋窝淋巴结清扫。142例SLNB代替ALND者中位随访时间18个月(3～64个月),均未发现腋窝淋巴结转移。结论:亚甲蓝法SLNB安全、有效、简便易行,SLNB阴性患者,可以替代ALND。

Application of Methylene blue in sentinel node biopsy of breast cancer

Objective:To explore the clinical value of methylene blue in sentind node biopsy(SLNB)in breast cancer.Methods:A xilla sentinel node resection was performed in 172 patients with breast cancer after subcutaneous injection with methylene blue,these sentinel nodes were checked by cryo-pathologic examination,and by litho-biopsy examination after the operation.Then,modified radical mastectomy was done in these patients.Results:The SLNB was completed successfully in 167 of the patients(97.1%);in the other5 cases(2.9%),no SLN was detected,and thus ALND was carried out.In the 167 cases who received SLNB,SLN metastasis wag found in 21 cases,which then underwent ALND as well.After the operation,HE staining showed lymph nodes micrometastasis in 5 patients;4 of them therefore received ALND(the other patient refused any further operation).Totally 142 patients had the SLNB instead of ALND,these patients were followed up for 18 months(ranged from 3 to 64months),during which no axillary metastasis was detected.Conclusion:Subareolar injection of methylene blue is effective,safe,and convenient for the treatment of patients with negative SLNB.It is a good alternative for ALND.