99Tcm硫胶体联合美蓝在乳腺癌前哨淋巴结活检中的临床应用价值

目的 探讨99Tcm硫胶体(99Tcm-sulfur colloid,99Tcm-SC)联合美蓝在早期乳腺癌前哨淋巴结活检(SLNB)中的可行性、准确性及临床应用价值.方法 采用99Tcm-SC联合美蓝对76例T1～ 2N0M0乳腺癌患者进行SLNB,将切除的前哨淋巴结行病理检查了解其符合率,探讨联合法在早期乳腺癌SLNB中的临床应用价值.结果 成功确定患者前哨淋巴结76例,7例前哨淋巴结病理检测阳性并行腋窝淋巴结清扫,99Tcm-SC灵敏度为85.7％ (6/7),准确性为98.7％( 75/76),假阴性率为14.3％( 1/7),美蓝法灵敏度为71.4％ (5/7),准确性为97.4％ (74/76),假阴性率为28.6％ (2/7).联合法灵敏度、准确性为100.0％(7/7,76/76),假阳性率为0(0/7).结论 99Tcm-SC联合美蓝可明显降低早期乳腺癌SLNB的假阴性率.

The important value of ^99Tc^m-SC combining methylene blue in sentinel lymph node biopsy of breast cancer

Objective To study the feasibility and accuracy of sentinel lymph node biopsy（SLNB） in early breast cancer. Methods In 76 cases of T1 or T2 breast cancer, Sentinel lymph nodes identified by ^99Tc^m-sulfur colloid （^99Tc^m-SC） combining methylene blue were excised for biopsy. Sentinel lymph node was examined pathologically to observe the conformance rate and to study value of the combination approach of SLNB of early breast cancer. Results Sentinel lymph node was identified in 76 cases. In 7 cases axillary lymph node dissection was performed because the SLNB was positive. The sensitivity rate of ^99Tc^m-SC and methylene blue method was 85.7% （6/7） and 71.4% （5/7）. The accuracy rate of 99Tcm-SC and methylene blue method was 98.7% （75/76） and 97.4% （74/76）. The false negative rate of 99Tcm-SC and methylene blue method was 14. 3% （1/7） and 28.6% （2/7）. The sensitivity rate and the accuracy rate of combination method was 100% （7/7, 76/76 ）. The false positive rate was zero（0/7）. Conclusion ^99Tc^m-SC combining methylene blue can decrease the false negative rate of SLNB in early breast cancer.