早期乳腺癌前哨淋巴结的临床研究

Clinical research of sentinel lymph node biopsy for early breast cancer

目的研究早期乳腺癌前哨淋巴结活检(sentinel lymph node biopsy,SLNB)的必要性、可行性、准确性及临床应用价值.方法采用活性蓝对32例T1～2N0M0乳腺癌患者进行SLNB.随后常规行腋窝淋巴结清扫(axillary lymph node dissection,ALND),将切除的前哨淋巴结(SLN)和腋窝淋巴结(ALN)同时送病理检查,了解其符合率,探讨SLNB在早期乳腺癌中的临床应用价值.结果成功确定患者SLN 31例,成功率为96.9%(31/32);SLN阳性9例(29.0%),SLN阴性22例(70%);ALN阳性10例(31.3%),ALN阴性22例(68.8%);SLNB的灵敏度为90.0%,准确性为93.8%,假阴性率为10.0%,假阳性率为0.结论 SLNB可以准确地预测早期乳腺癌患者ALN的组织学特征,利用活性蓝作为显示剂可以提高SLNB的成功率.

Objective To study the necessity,feasibility,accuracy and clinical applied value of sentinel lymph node biopsy（SLNB） in early breast cancer. Methods In 32 cases with early breast cancer, sentinel lymph nodes identified by vital blue was excised for biopsy. The patients then received operations for breast cancer,including axillary lymph nodes dissection. SLN and axillary lymph nodes（ALN） were separately examined histopathologically to acquaint the conformance rate and to explore the clinical applied value of SLNB in early breat cancer. Results SLN was identified in 31 cases,success rate was 96.9 % ,in 9 of the 31 patients,SLN was positive for metastasis,in 22 of the 31 patients,SLN was negative for metastasis,in 10 of 32 patients,ALN was positive for metastasis, and in 22 of 32 patients,ALN was negative for metastasis. The sensitivity rate of SLNB was 90 %. The accuracy rate was 93. 8% ,with a false negative rate of 10% and a false positive rate of zero. Conclusion The SLNB can accurately predict the axiilary metastasis for patients with early breast cancer. Vital blue tracing may increase the success rate of SLNB.