早期浸润性乳腺癌前哨淋巴结活检术学习曲线分析

目的：探讨前哨淋巴结活检术的学习曲线。方法：选取2011年3月—2012年10月行乳腺癌改良根治术的60例早期浸润性乳腺癌患者作为研究对象，按照手术时间的先后顺序分别为A，B，C组，每组20例，所有研究对象在进行改良根治术前先行腋窝前哨淋巴结活检，比较各组的手术时间、前哨淋巴结活检成功率、假阴性率及灵敏度。结果：A，B，C组手术时间分别为（36.6±8.2）min，（25.1±7.4）min，（17.3±5.6）min，各组间差异有统计学意义（P<0.05）。A组前哨淋巴结活检的成功率为65.0%，假阴性率为55.6%，灵敏度为44.4%；B组分别为95.0%，11.1%，88.9%；C组分别为100.0%，0，100.0%；各组间差异均有统计学意义（均P<0.05）。结论：在规范化地进行20例前哨淋巴结活检术后，即可基本掌握前哨淋巴结活检术的手术技术；经过40例的手术实践后，可以达到较为熟练的程度。

Analysis of the learning curve for sentinel lymph node biopsy in early-stage invasive breast cancer

Objective: To analyze the learning curve of sentinel lymph node biopsy in early-stage invasive breast cancer.Methods: Sixty patients with early-stage invasive breast cancer undergoing modified radical mastectomy between March 2011 and October 2012 were enrolled. The patients were divided into group A, B and C according to the time order of operation, with 20 cases in each group. The patients underwent sentinel lymph node biopsy before modified radical mastectomy. The operative time, success rate, false negative rate and sensitivity of sentinel lymph node biopsy among groups were compared.Results: The operative time in group A, B and C was (36.6±8.2), (25.1±7.4) and (17.3±5.6) min respectively, and there was statistical difference among the three groups (P<0.05). The success rate, false negative rate, and sensitivity of sentinel lymph node biopsy in group A was 65.0%, 55.6% and 44.4%, in group B was 95.0%, 11.1% and 88.9%, and in group C was 100.0%, 0 and 100.0% respectively, and all the differences in these parameters were statistically different (all P<0.05).Conclusion: With the completion of 20 performances of standardized sentinel lymph node biopsy, one can basically grasp this technique, and may reach full mastery after 40 performances.