乳腺癌前哨淋巴结的临床病理意义

目的:探讨乳腺癌淋巴结勘测性前哨淋巴结活检对于临床病理的意义.方法:对54例 T1及T2浸润性乳腺癌患者实行勘测性前哨淋巴结切除术(sentinel lymph node dissec tio n, SLND)和腋窝淋巴结切除术(axillary lymph node dissection, ALND).T1肿瘤直径< 2 cm,T2肿瘤直径2～5 cm.乳腺癌前哨淋巴结(sentinel lymph node,SLN)的勘测用活性蓝示踪法识别.SLN经常规苏木精和伊红(hematoxylin and eosin,HE)染色、病理分析及连续多层切片检查.结果:54例T1及T2浸润性乳腺癌100%发现前哨淋巴结,共切除168个,1 5例29个前哨淋巴结见癌转移,SLN及腋窝淋巴结(axillary lymph node,ALN)均未转移38 例,SLN癌转移、ALN未见转移5例,SLN及ALN均见转移10例,SLN假阴性1例.常规病理检查阴性的SLN经过连续多层面切片1例发现微小转移灶.结论:SLND对于发现乳腺癌腋下转移有高的敏感性,是一个有用的、准确评价腋窝淋巴结转移的方法.

Sentinel lymph node biopsy in breast cancer

Objective: To study the clinicopathological significance of mapping sentinel lymph node dissection (SLND) in breast cancer. Methods: 54 women with T 1 or T 2 breast cancer underwent intraoperative lymph mapping using vital blue dye. The sentinel lymph node (SLN) was examined grossly, by standard H&E histology. Results: SLN was successfully identified in 54 patients. Of the 54 patients, 168 SLN's were dissected, 15 patients had SLN metastases; 38 cases with T 1 or T 2 tumor had no metastases to the SLN and ALN; 3 cases with T 1 tumor and 2 cases with T 2 tumor had metastases to the SLN, and had no metastases to the ALN;3 cases with T 1 tumor and 7 cases with T 2 tumor had metastases to the SLN and ALN. Conclusion: SLND could predict the axillary status of breast cancer patients accurately, improve the accuracy of the axillary staging of breast cancer and decrease the extent of surgery and postoperative complication.