前哨淋巴结活检术在早期乳腺癌治疗中的疗效分析

目的对比早期乳腺癌行前哨淋巴结活检术(SLNB)与行SLNB加腋窝淋巴结清扫(ALND)后的并发症及远期预后。方法回顾性分析2012年10月至2013年10月50例早期乳腺癌前哨淋巴结阴性患者,并将其分为腋窝淋巴结保留组与腋窝淋巴结清扫组,每组25例。保留组行SLNB治疗,清扫组在保留组的治疗基础上加行ALND。采用SPSS19.0软件进行统计分析,年龄、平均住院时间计量资料用(x珋±s)表示,采用t检验;病理特征、并发症、生存率两组比较采用χ2检验。P0.05时差异有统计学意义。结果 50例患者共检出前哨淋巴结(SLN)87个,平均每例检出1.74个。保留组共检出SLN 42枚,平均检出1.68枚,清扫组共检出SLN 45枚,平均检出1.8枚(χ2=0.180,P0.05)。出现并发症的例数:保留组为4例(16.0%),清扫组为15例(60.0%);平均住院时间:保留组为(6.0±1.1)d,清扫组为(8.3±1.7)d。保留组的术后住院时间及并发症均明显少于清扫组,且两组比较均有统计学意义(t=5.679,χ2=10.272,P0.05)。50例患者随访2~3年,随访率100%。截至2015年6月,两组患者术后两年生存率均为100%,无瘤生存率均为100%。结论 SLNB经济实用、安全可靠、推广方便,能够较准确地预测乳腺癌腋窝淋巴结的分期状态,可以减少不必要的腋窝淋巴结清扫及其术后并发症的发生。

Clinical analysis of sentinel lymph node biopsy in treating early breast cancer

Objective To compare the complications and long-term clinical outcome of patients with early breast cancer who received sentinel lymph node biopsy with or without axillary lymphnode dissection (ALND). Methods From October 2012 to October 2013, clinical data of 50 patients with early breast cancer and negative sentinel lymph node were analyed retrospectively , all of whom was divided into axillary lymph retention group (25 cases) and axillary lymph node dissection group (25 cases).Patients in retention group underwent only SLNB treatment , while additional ALND were performed in axillary lymph node dissection group .Statistical analysis were performed by using SPSS 19.0 software.Measurement data were expressed as (x±s) and examined by t test, including age, average length of stay.Pathological features, complications, and survival rate between two groups were compared by using χ2 test.P<0.05 was considered as statistically significant difference . Results A total of 87 SLN were harvested in 50 patients (mean of 1.74), including 42 SLN in retention group with an average of 1.68 and 45 harvested SLN in axillary lymph node dissection group with an average of 1.8 (χ2 =0.180, P>0.05).4 cases (16.0%) of complications occurred in retention group , and 15 cases (60.0%) in axillary lymph node dissection group . The average length of stay was (6.0 ±1.1) d in retention group, and (8.3 ±1.7) d in axillary lymph node dissection.Postoperative hospital stay and complications in retention group were significantly less than those in axillary lymph node dissection group , with statistically significant difference (t=5.679,χ2 =10.272, P<0.05).Until to June 2015, 50 patients were followed up for 2 to 3 years, and the follow-up rate was 100%. Postoperative 2-year survival rate and disease-free survival rate were 100% in both two groups .Conclusion SLNB is economical and practical , safe, reliable and convenience , could accurately predict axillary lymph node in breast cancer staging , and also could reduce unnecessary axillary lymph node dissection and postoperative complications .