乳腺癌新辅助化疗后蓝染法行前哨淋巴结活检术的临床分析

【摘要】 目的 研究乳腺癌患者新辅助化疗后蓝染法行前哨淋巴结活检术(SLNB)的可行性。方法〓回顾性分析2012年1月至2015年6月初诊于广西柳州市工人医院普外四病区的IIA-IIIB期乳腺癌患者69例。所有患者均接受新辅助化疗,疗程4~8个周期,分析新辅助化疗后蓝染法行SLNB的检出率、假阴性率。结果〓入组患者SLNB检出率为85.5%,假阴性率为18.2%;SLNB的检出率因腋窝淋巴结状态不同而存在统计学差异,在不同肿瘤的大小、肿瘤位置、患者年龄和SLNB时注射染料位置无统计学差异,假阴性率在上述不同分组中均无统计学差异。结论〓NAC后蓝染法SLNB可应用于治疗前腋窝淋巴结阴性的乳腺癌患者;对于治疗前腋窝淋巴结阳性的患者则存在风险。增加SLN检出数目可增加NAC后行SLNB的可靠性。

Analysis of sentinel lymph node biopsy by blue dye trace method for breast cancer patients after neoadjuvant chemotherapy

Objective To assess the feasibility of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods Sixty-nine patients with breast cancer were subjected to pre-operative NAC from 2012-01-01 to 2015-06-30 in Liuzhou Worker’s hospital, and their clinical data of sentinel lymph node biopsy (SLNB) from axillary lymph nodedissection (ALND) were analyzed. SLN identification rates and false negative rate of the patients were assessed. Results The identification rate for SLNB was 85.5%. The false-negative rate was 18.2%. Grouping the patients according to axillary lymph node (ALN) state before treatment, the size of the tumor,.location of the tumor,.the age of the patients and the injection site of blue dye,.the identification rates of ALN (-) group and ALN(+) group were 96.7%and 76.9%(P=0.049) respectively,. and had nothing to do with the left factors mentioned above. There was no statistical difference of the false-negative rate in different states of all the factors. Conclusion SLNB by blue dye trace method is feasible in ALN (-) breast cancer patients who have received NAC , while there are some risks for ALN (+) patients. Increasing the number of SLN might elevate the reliability of SLNB in patients after NAC.