早期乳腺癌前哨淋巴结活检替代腋窝淋巴结清扫的临床应用研究

目的 对前哨淋巴结活检(sentinel lymph node biopsy,SLNB)替代腋窝淋巴结清扫(axillary lymph node dis-section,ALND)在早期乳腺癌患者中的应用以及安全性研究及探讨.方法 回顾性分析行SLNB和ALND手术的503例早期乳腺癌病例,对患者住院时间、拔管时间及住院费用进行对比,以及对患者上肢并发症、腋窝局部复发及远处转移情况进行随访,随访至2016年06月,中位随访时间为32(6 ～52)个月.结果 在住院时间、拔管时间、住院费用以及上肢并发症方面,SLNB组明显优于ALND组,差异有统计学意义,而在腋窝局部复发及远处转移情况方面两组无统计学意义.结论 在SLN阴性早期乳腺癌中,SLNB与ALND可以取得相同的疗效,而且,SLNB与ALND相比,手术创伤小,麻木疼痛、肩关节活动受限等术后并发症明显减少,且可缩短患者住院时间,减轻患者的经济负担.

Clinical Application of Sentinel Lymph Node Biopsy Instead of Axillary Lymph Node Dissection for Early Breast Cancer

Objective To discuss the application value and safety of sentinel lymph node biopsy(SLNB) instead of axillary lymph node dissection(ALND) for patients with early breast cancer.Methods Retrospective analysis was performed on 503 early breast cancer cases treated by SLNB and ALND surgery.The time of hospitalization,the time of extubation and the cost of hospitalization were compared,and the complication of upper extremity,axillary recurrence and distant metastasis were followed up untill June 2016,Median follow-up time was 32 (range,6 to 52) months.Results The time of hospitalization,the time of extubation,the cost of hospitalization and the complications of upper extremity,SLNB group was obviously superior to ALND group,the difference was statistically significant.There was no statistical difference in local recurrence and distant metastasis.Conclusion SLNB and ALND can achieve the same effect in SLN negative early-stage breast cancer.Compared with ALND,SLNB had less postoperative complications,such as postoperative pain,numbness and pain,and limited shoulder movement,and shortened the length of hospital stay,reduced the economic burden of patients.