前哨淋巴结检测在乳腺癌治疗中的意义

The clinical significance of sentinel lymph node biopsy in breast cancer surgery

目的评价前哨淋巴结活检术 (sentinellymphnodebiopsy,SLNB)预测腋淋巴结肿瘤转移的准确性及其临床意义。方法使用专利蓝染色法和 /或99mTc标记的硫胶体示踪法对我院收治的81例乳腺癌患者进行前哨淋巴结活检。两种方法联合检测 3例前哨淋巴结 (sentinellymphnode ,SLN)均阴性者未行腋淋巴结清扫术。结果 81例患者SLN总检出率为 96 3% (78/81) ,总准确率为97 5 % ,总假阴性率 9 7%。 5 3例单纯染色法检出率为 92 5 % ,准确率 94 2 % ,假阴性率 15 8% ;2 8例99mTc示踪法和 /或染色法联合检测结果分别为 10 0 % ,10 0 %和 0。结论SLNB能够准确预测腋窝淋巴结的转移状况。两种方法联合检测为最佳。术前化疗对假阴性率可能有影响。

Objective To evaluate the accuracy of sentinel lymph node biopsy (SLNB) in predicting the axillary lymph node status in breast cancer patients undergoing a breastectomy. Methods From Mar 2002 to Jun 2003,patent blue dye and/or 99m Tc-Sc were used to detect sentinel lymph nodes,samples were sent for fast pathology.Three patients in which the SLN were judged as negative by both the two tests were freed of futher axillary lymph node dissection (ALND). Results SLN were successfully identified in 78 of 81 (96.3%) patients. The accuracy rate of SLNB to predict axillary lymph node status was 97.5%,with 9.7% false negative rate. The success rate,accuracy rate and false negative rate by blue dye only and by a combination of two above methods were 92.5%,94.2%,15.8%,and 100%,100%,0, respectively . Conclusions SLNB accurately predict the axillary status in clinically node negative breast cancer patients .