专利蓝与^(99m)Tc-硫化锑胶体联合鉴别乳腺癌SLN

Identified SLN with combination of Patent blue violet and ^(99m)Tc-antimony trisulfide colloid in patients with breast cancer

目的探讨术中鉴别定位乳腺癌前哨淋巴结(Sentinel Lymph Node, SLN)的最佳方法。方法从2001年4月~2003年6月,98例I,II期乳腺癌先后接受了前哨淋巴结活检(Sentinel Lymph Node Biopsy, SLNB)。其中44例用单一蓝染法(A组),54例应用同位素显像+γ探头扫描+蓝染法(B组)分别进行SLN的示踪定位,97例行腋淋巴结清扫,1例行保乳保腋窝手术。结果成功地在88例(89.8%)病人中鉴别定位SLN;两种定位方法的成功率分别为:A组81.8%(36/44),B组96.3%(52/54);以腋清扫常规病理诊断为标准,判定SLN诊断符合率为95.4%(83/87),假阴性诊断4例。结论应用专利蓝与99mTc-硫化锑胶体联合法较单一专利蓝法鉴别定位SLN的成功率高,具有统计学意义。

Objective: To evaluate the best approaches of identifying sentinel lymph node (SLN) during sentinel lymph node biopsy (SLNB) in patients with breast cancer. Methods: Between Apirl 2001 and June 2003, 98 patients with I-II stage breast cancer were enrolled consecutively in this study. SLNB were performed in all patients using patent blue violet alone (A), or combining lymphoscintigraphy, γ-probe scanning and patent blue violet (B). SLNs was identified with approach A in 44 patients, B in 54 patients, respectively. Results: SLNs was successfully identified in 88 (89.8%) of 98 patients. The identification rates of different approaches were 81.8%(36/44) and 96.3(52/54), respectively. The rate of predicted accuracy of SLNB was 95.4%(83/87) based on the standard of HE staining of lymph nodes under ALND. The false negative was appeared in 4 patients. Conclusions: Our study suggestes the identification of SLN with breast cancer.