亚甲蓝示踪法定位乳腺癌前哨淋巴结的评价

目的 评估亚甲蓝在乳腺癌前哨淋巴结活检（SLNB）中的应用价值。方法 对100例临床分期为T1-2N0M0的乳腺癌患者，术中用1%亚甲蓝注射在原发肿瘤周围进行腋淋巴结定位并前哨淋巴结切除；随即行乳腺癌根治或改良根治切除术，全部标本作病理学检查。结果 本组100例患者中78例发现了前哨淋巴结（SLN），占78%，发现前哨淋巴结的患者中40例（51.2%)有腋窝淋巴结癌转移，其中有3例SLN阴性，用亚甲蓝为示踪剂SLNB的准确率为96.1%(75/78)，假阴性率为7.5%(3/40)；SLN对腋窝淋巴结状况预测的敏感性为92.5%(37/40)；阳性预测值和阴性预测值分别为100%和90.2%。结论 亚甲蓝示踪法在探查乳腺癌前哨淋巴结估测癌转移，指导根治切除术范围具有临床应用价值。

Evaluation of methylene blue method for sentinel lymph node biopsy in breast cancer

Objective To summarize and evaluate the application of methylene blue for sentinel lymph node biopsy (SLNB) in breast cancer.Methods One hundred cases of breast cancer with T 1?2 N 0M 0 stage were studied.During surgery,radical or modified mastectomy was preceeded following injection of 1% methylene blue around the primary tumor,to locate axillary lymph nodes and resect of sentinel lymph nodes (SLN).The resected specimens were examined.Results SLN was found in 78 of 100 cases (78.0%),in the 78 patients,40 (51.2%) had histologically positive axillary lymph nodes,including 3 patients with negative SLN.The accuracy of SLNB to predict the axillary lymph node status was 96.1% and false negative rate 7.5% (3/40).The sensitivity of methylene blue tracing in this study was 92.5 %(37/40).The positive and negative predictive values were 100% and 90.2%.Conclusion With improvement of technique and accumulation of experience,methylene blue tracing in biopsy of SLN is effective in clinical practices.