前哨淋巴结活检对乳腺癌外科导航的临床分析

A clinical analysis of the surgery value of sentinel node biopsy in beast cancer

目的 探讨前哨淋巴结活检 (SLNB)对乳腺癌手术导航的临床价值及可靠性。方法 用染料法(1%亚甲蓝 )对 30例乳腺癌病人进行腋窝前哨淋巴结 (SLN)染色切除。术中冰冻切片 ,术后石蜡切片 ,并常规行腋窝淋巴结清除术 (ALND)。结果 SLN染色成功率 96 7% (2 9/ 30 ) ,失败 1例。SLN阳性 10例 ,后站淋巴结有癌转移 6例 (6 0 % ) ,无癌转移 4例 (4 0 % )。SLN阴性 19例 ,其中假阴性 1例 ,后站淋巴结均无癌转移。SLNB评价 :检出率 96 7%、准确率 93 3%、敏感度 90 9%、假阴性率 9 1%、假阳性率 0。结论 只要提高技术水平 ,SLN染料着色和检出率都相对较高 ,对外科术式选择有实际指导意义。相信SLNB取代传统的ALND已为时不远。

Objective To analyze the clinicla value and reliability of sentinel lymph node biopsy(SLNB)in breast cancer surgery.Methods Thirty breast cancer patients had been operated by sentinel node biopsy and stained with 1% methylene blue.There had Gryo-section during operation and paraffin wax-section after operation.Operation concluded excision of axillary lymph node.Results The successful rate of sentinel node stain was 96.7%(29/30),one patient's sentinel node hadn't stain with this method,10 patients had positive sentinel node,in these patients,6 had another axillary node metastasis and 4 hadn't another axillary node metastasis.Nineteen patients had negative sentinel node,but one patient had false-negative result.The evaluation of SLNB:The usccessful rate was 96.7%,accuracy was 93.3%,sensitivity was 90.9%,false-negative rate was 9.1% and false-positive rate was 0.Conclusion At present,many factors and problems need deep research in SLNB,so the SLNB of breast cancer is in clinical investigation stage.But we think not long after the old ALND is going to substitute with SLNB.