美蓝在乳腺癌前哨淋巴结活检中的临床价值

目的探讨美蓝在乳腺癌前哨淋巴结活检中的临床价值。方法将1%美蓝2ml注入活检腔外上方的皮下及乳腺组织内,然后行Auchincloss仿根治术,依淋巴管走向找到蓝染淋巴结定为SLN,若此时未找到待腋窝清扫结束后,再在标本中寻找,蓝染者为SLN,余为非SLN,分别送病理检查。结果前哨淋巴结检出率为87.9%(95/108),SLN预测腋窝状况的准确率为95.7%(91/95),假阴性率为6.5%(4/62),无假阳性者。未检出者13例,其中4例为假阴性,均属跳跃式转移。前哨淋巴结转移阳性率(34.6%,33/95)和阴性率(65.3%,62/95),与全腋淋巴结转移阳性率(39.8%,43/108)和阴性率(60.2%,65/108)比较,均无显著性差异(P>0.05)。结论美蓝前哨淋巴结活检可以准确预测乳腺癌患者的腋淋巴结状态。

Significance of Sentinel Lymph Node Biopsy with Methlene Blue in Breast Cancer

Objective To study the significance of sentinel lymph node biopsy(SLNB) with methylene blue in breast cancer.Methods During the axillary lymph node dissection(ALND) operation,2 ml 1% methylene blue was injected around the lumen.All stained lymph nodes were considered as SLN.All the acquired lymph nodes,including SLN or NSLN,underwent phathological examination.Results SLN were identified in 95 of 108 patients(87.9%).Histologic status of the SLNs accurately predicted axiliary nodes status with an accuracy rate of 95.7%(91/95).The false negative rate is 6.5%.and false positive was 0.4 false negative cases were skip metastasis.The positive and negative metastasis rates were 34.6% and 65.3% for SLN,39.8% and 60.2% for axillary lymph nodes,not showing a significant difference between them(P>0.05).Conclusion SLN could accurately predict the axillary node status in patients with breast cancer.