应用前哨淋巴结活检术指导乳癌手术方式的临床研究

Clinical Application of Sentinel Lymph Node Biopsy Guided Opration of Breat Cancer

目的 探讨开展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 应用美蓝5mL于原发肿瘤上、下、左、右选4点行皮下及乳腺组织注射．5～15min后仔细解剖，根据蓝染标记切除SLN．所有患者行同期根治术，切除SLN与区域清扫标本同时送病理检查，了解其符合率。并评价SLNB的可行性．结果 30例均进行SLN识别定位，活检后经病理检查有2例错误．1例未取到SLN，故SLN的检出率为96．7％；1例SLN病理呈假阴性．按目前国外SLNB的评价标准，本组SLNB的敏感度为88．9％，准确率为93．3％，假阳性率为0，假阴性率为11．1％．结论 乳腺癌SLNB目前在国内外仍处于研究阶段，随着研究的扩大与深入将可能取代常规的ALND．

Objective To study the necessity, feasibility, accuracy and value of sentinel lymph node biopsy （SLNB）in the management of breast cancer. Methods Beautiful blue 5 mL was injected into the mammary tissue around the tumor at four points. After 5～15 minutes, SLN in breast cancer was detected and dissected with the help of beautiful blue. Rountine lymph node dissction was performed for all patients. 30 cases was performed SLN. Results In 30 cases, negative rate was 11.1%. Conclusion SLN biopsy, though still under investigation, may substitute routine axillary lymph node dissection in the management of breast cancer in future.