前哨淋巴结活检对乳腺癌新辅助化疗后腋窝状况评估中的价值

目的 研究前哨淋巴结活检在乳腺癌新辅助化疗后的临床应用价值。方法 选择我院2007年9月至2010年11月期间收治的46例Ⅱ、Ⅲ期乳腺癌患者，接受新辅助化疗后超声检查腋窝淋巴结阴性者为研究对象。所有患者前哨淋巴结活检后行乳腺癌改良根治术及标准腋窝淋巴结清扫，所有前哨淋巴结行病理和免疫组化检查，非前哨淋巴结行常规病理检查。结果 前哨淋巴结活检的成功率、假阴性率、灵敏度、特异性、精确性、阳性预测值、阴性预测值分别是93.5%，3.7%，96.3%，100%，97.7%，100%，94.1%。结论 前哨淋巴结活检结合超声可以较准确的评价新辅助化疗后乳腺癌的腋窝淋巴结状态，对于决定患者是否需要行腋窝淋巴结清扫有一定参考价值。

The value of axillary sentinel lymph node biopsy for assessing breast cancer status after neoadjuvant chemotherapy

Objective To investigate the feasibility, accuracy and clinical significance of sentinel lymph node biopsy （SLNB） examination for breast cancer patients after neoadjnvant chemotherapy （NAC）. Methods a total of 46 breast cancer patients with stages Ⅱ and BI previously treated with NAC, from September 2007 to November 2010, were enrolled in the study. All patients were clinically node negative after NAC through ultrasound examination before performance of SLNB. Subsequently, the patients underwent the standard level of I/Ⅱ axillary lymph node dissection （ALND）. The SLN specimens were carried out histopathological examination with H＆E and immunohistochemstry and non-SLNs with routine histology. Results The success identitication rate, false negative rate, sensitivity, specificity, accuracy positive predictive value and negative predictive value of SLNB were 93.5%, 3.7%, 96.3%, 100%, 97.7%, 100% and 94.1%, respectively. Conclusion SLNB combined with ultrasound examination can be a more evaluation for axillary lymph node status after NAC and help surgeons to decide subsequent ALND.