核素法乳腺癌前哨淋巴结活检术临床应用探讨

Research of Radionuclide Method Applying in Sentinel Lymph Node Biopsy with Radionuclide in Breast Cancer

目的 评价核素法乳腺癌前哨淋巴结活检术对预测腋窝淋巴结状况的准确性,探讨其检查方法及临床应用意义.方法 应用99mTc-硫胶体作为示踪剂对46例临床分期为T1-2N0M0的乳腺癌患者进行前哨淋巴结活检,所有患者均同时行腋窝淋巴结清扫,统计其发现率、准确率、假阴性率、假阳性率.结果 46例乳腺癌患者中,38例检出前哨淋巴结,检出率为82.61%,平均每例1.4枚(1～3枚),清扫腋窝淋巴结平均每例10.8枚(4～19枚).用前哨淋巴结预测腋淋巴结转移的94.74%,准确率为94.74%,特异度为100%,假阴性率为5.26%.结论 核素法前哨淋巴结活检术能较准确预测腋窝淋巴结转移情况,但病例的选择有一定的适应症,与术者操作经验有关.

Objective To evaluate the accurate of sentinel lymph node biopsy (SLNB) with radionuclide in breast cancer in predicting the status of axillaries nodes,approach the detection method and the significance of clinical application.Methods Forty-six cases of breast cancer with T1-2N0M0 stage were studied.Appling the 99mTc-sulfur colloid for the tracer in SLNB,all patients were performed axillaries lymph node dissection (ALND) and were counted the detective rate,accuracy,false negative rate,false positive rate.Results SLN was found in 38 of 46 cases (82.61%),the number of SLN was 1.4 (1~3) in every case averagely.The sensitivity,accuracy,specifity and false negative rates of SLN to predict axillaries lymph node status were 94.74%,94.74%,100%,5.26%.Conclusions Sentinel lymph node biopsy with radionuclide can exactly predict axillaries lymph node status,but the indication of the choice cases is limited,and positive rate is correlated to the experiences of the operator.