乳腺癌前哨淋巴结活检技术的临床应用

Clinical application of sentinel lymph node biopsy in patients with early breast cancer

目的:探讨前哨淋巴结活检(Sentinellymphnodebiopsy ,SLNB)在乳腺癌外科中的应用,并评价其准确性及可行性。方法:对2 0 0 2 - 0 1～2 0 0 4 - 0 1我院收治的16 1例Ⅰ、Ⅱ期乳腺癌病例,在常规行乳腺癌手术前均进行SLNB ,即肿瘤局部皮内联合注射99mTc-DX及美蓝,根据核素示踪及美蓝染色结果寻找SLN并摘除,行冰冻病理检查。将SLNB结果与术后腋窝淋巴结病理结果进行分析。结果:16 1例中14 9例发现SLN ,检出率为92 .5 % (14 9/ 16 1) ;共检出SLN 2 73个,平均1.83个/例。比较SLNB与术后病理结果,SLNB检出灵敏度为96 .1% (49/ 5 1) ,准确性98.7% (14 7/ 14 9) ,假阴性率3.9% (2 / 5 1) ,假阳性率0。结论:SLN可比较准确地反映腋窝淋巴结状况。

Objective:To investigate the accuracy a nd feasibility of sentinel lym ph node biopsy(SLNB) in the early breast cancer. Methods: SLNB was performed in 161 patients with Ⅰ, Ⅱ phase breast cancer, who we re admitted to our hospital from Jan 2002 to Jan 2004. The results of SLNB were compared w ith pathological findings during operation. Results: A total of 149 patients found SLN, the positive rate was 92.5%. Altogether 273 SLN we re detected in 161 patients, with a mean of 1.83 SLN per case. After comparison with the operation findings, it was found that the sensitivity,accuracy,false ne gative rate and false positive rate of SLNB were 96.1%, 98.7%, 3.9% and 0, resp ectively. Conclusion: SLNB is a new technique for br east cancer.It is practical and easy to master. ALND w ill be replaced by SLNB for those without axillary lymph metastases in the futur e.