乳腺癌前哨淋巴结的临床研究

目的　评价乳腺癌前哨淋巴结活检(sentinellymphnodebiopsy ,SLNB)的必要性、可行性、准确性及临床应用价值。方法　利用脂质体 亚甲蓝混合物对本院 2 0 0 1年 6月～ 2 0 0 2年 12月收治的 32例T1～ 2 N0 M0 乳腺癌患者进行SLNB。随后常规行腋窝淋巴结清扫(axillarylymphnodedisescetion,ALND)。将切除的前哨淋巴结 (SLN)和腋窝淋巴结 (ALN)同时送病理检查 ,了解其符合率 ,并评价SLNB在早期乳腺癌中的可行性及临床应用价值。结果　成功确定患者SLN 31例 ,共 5 7枚 ,成功率为 96 .9% (31/ 32 ) ;SLN阳性 9例(2 9.0 % ) ,SLN阴性 2 2例 (70 % ) ;ALN阳性 10例 (31.3% ) ,ALN阴性 2 2例(6 8.8% ) ;SLNB的灵敏度为 90 .0 % ,准确性为 93.8% ,假阴性率为 10 .0 % ,假阳性率为 0。结论　SLNB可以准确地预测乳腺癌患者ALN的组织学特征 ;利用脂质体 亚甲蓝混合物作为显示剂可以提高SLNB的成功率

CLINICAL STUDY OF SENTINEL LYMPH NODE BIOPSY FOR BREAST CANCER

Objective To evaluate the necessity, feasibility, accuracy and clinical value of sentinel lymph node (SLN) biopsy (SLNB) in early breast cancer. Methods In 32 cases with early breast cancer, sentinel lymph nodes identified by liposomes methylence blue mixture were excised for biopsy. The patients then received operations for breast cancer, including axillary lymph nodes dissection. SLN and avillary lymph nodes (ALN) were separately examined histopathologically. Results SLN was identified in 31 cases, success rate was 96.9%. In 9 of the 31 patients, SLN was positive for metastasis, in 22 of the 31 patients, SLN was negative for metastasis. In 10 of 32 patients, ALN was positive for metastasis, and in 22 of 32 patients, ALN was negative for metastasis. The sensitivity rate of SLNB was 90%, The accuracy rate of SLN was 93.8%, with a false negative rate of 10% and a false positive rate of zero. Conclusion The SLN biopsy can accurately predict the axillary metastasis for patients with breast cancer. Liposomes methylenc blue mixture tracing may increase the success rate of SLNB.