前哨淋巴结活检术辅助手术治疗乳腺癌及对腋窝淋巴结分期的预测作用

目的探究前哨淋巴结活检术(SLNB)辅助手术治疗乳腺癌及对腋窝淋巴结分期的预测效果。方法选取2018年1月至2020年12月本院收治的82例乳腺癌患者作为研究对象,随机分为两组,各41例。对照组采用腋窝淋巴结清扫术与乳腺全切术治疗,观察组根据前哨淋巴结活检术病理结果确定是否对患者实施腋窝淋巴结清扫术治疗。比较两组手术时间、住院时间、血清肿瘤标志物及并发症发生率,并探究前哨淋巴结活检术对淋巴分期的预测价值。结果观察组手术时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组血清肿瘤标志物水平比较差异无统计学意义;治疗后,观察组血清肿瘤标志物水平均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为12.20%,低于对照组的39.03%,差异有统计学意义(P<0.05)。观察组前哨淋巴结活检检出率为97.56%(40/41),在每例患者中发现1~3枚前哨淋巴结,前哨淋巴结共57枚。通过开展HE染色和连续切片,发现前哨淋巴结阳性率为41.46%(17/41),其中微转移4例。结论乳腺癌患者开展手术治疗前行前哨淋巴结活检术,能有效评估腋窝淋巴结情况,准确判断是否开展腋窝淋巴结清扫术,降低患者术后并发症发生率,缩短手术时间与住院时间,促进机体恢复。

Sentinel lymph node biopsy adjuvant surgery for breast cancer and its predictive effect on axillary lymph node staging

Objective To explore sentinel lymph node biopsy(SLNB) adjuvant surgery for breast cancer and its predictive effect on axillary lymph node staging. Methods 82 breast cancer patients admitted to our hospital from January 2018 to December 2020 were selected as the research subjects, and they were randomly divided into two groups, with 41 cases in each group. The control group was treated with axillary lymph node dissection and total breast resection. The observation group determined whether to perform axillary lymph node dissection based on the results of sentinel lymph node biopsy. The operation time, hospital stay, serum tumor markers and complication rate were compared between the two groups, and the predictive value of sentinel lymph node biopsy for lymphatic staging was explored. Results The operation time and hospital stay of the observation group were shorter than those of the control group, and the difference was statistically significant(P<0.05). Before treatment, there was no significant difference in serum tumor marker levels between the two groups;after treatment, the serum tumor marker levels in the observation group were lower than those in the control group, and the difference was statistically significant(P<0.05). The incidence of complications in the observation group was 12.20%, which was lower than 39.03% in the control group, and the difference was statistically significant(P<0.05). The detection rate of sentinel lymph node biopsy in the observation group was 97.56%(40/41). 1-3 sentinel lymph nodes were found in each patient, there were 57 sentinel lymph nodes. Through HE staining and serial sectioning, the positive rate of sentinel lymph nodes was 41.46%(17/41), including 4 cases of micrometastasis. Conclusion Sentinel lymph node biopsy during surgical treatment of breast cancer can effectively assess the condition of axillary lymph nodes, accurately determine whether to perform axillary lymph node dissection, reduce the incidence of postoperative complications, shorten the operation time and hospital stay, and promote the recovery of the body.