乳腺癌前哨淋巴结微转移检测的临床预警价值

Clinical presentiment value of detection of sentinel lymph node micrometastasis in breast cancer

目的探讨提高乳腺癌前哨淋巴结(SLN)微转移检测的临床价值。方法对应用美兰染料法进行前哨淋巴结活检成功的60例早期乳腺癌的SLN和腋窝淋巴结(ALN)进行常规病理学检查(HE染色),并对所有的SLN进行细胞角蛋白19(CK-19)免疫组化(IHC)检测,以检测SLN的微转移灶,对结果进行分析。结果本组40例SLN阴性者检出微转移10例,检出率提高了16.67%(10/60),其中1例1年半后出现肝、肺多发转移;1例2年后出现同侧锁骨上淋巴结转移。结论免疫组化检测可提高乳腺癌前哨淋巴结微转移的检出率,降低假阴性率,并对预后判断、指导术后综合治疗有较高的临床价值。

Objective To investigate the clinical value of improvement in detection of sentinel lymph node（SLN） micrometastasis in breast cancer. Methods SLN of 60 patients with breast cancer were successfully detected with methylene blue,then both SLN and ALN were examined by hematoxylin and eosin staining（ HE staining）. SLN were examined with IHC examination of cytokeratin 19 （CK-19） to detect micrometastasis. Data were collected and analyzed. Results Ten cases were proved to have micrometastasis among 40 patients with negative SLN ,the detection rate rose by 16.67% （10/60）. One patient had hepatic and pulmonary metastasis one and a half year later, and another patient had superelavicular lymph node metastasis in the same side two years later. Conclusion IHC can improve the efficiency of estimate of mierometastasis in SLN, reduce the false-negative ratio, and is important in prognosis and indication of therapy after operation.