亚甲蓝染色法检测乳腺癌前哨淋巴结临床应用研究

Clinical application of intradermal methylthionine chloride injection to identify sentinel lymph node in breast cancer

目的:寻找检测乳腺癌前哨淋巴结(sentinel lymph node,SLN)的方法,并研究前哨淋巴结活检(sentinel lymph node biopsy,SLNB)预测腋窝淋巴结状况的准确性。方法:对81例乳腺癌患者进行亚甲蓝染色法检测SLN,并与腋窝淋巴结切除术(axillary lymphnode dissection,ALND)后的淋巴结转移状况进行对比分析。全部病例均经病理证实。结果:81例患者中成功检测出SLN79例,成功率为97%。共检出SLN166个,平均每例检出2.1个。共出现3例假阴性结果,未有假阳性,假阴性率为3%。79例患者中有30例SLN阳性,阳性率为38.0%;共检测出SLN66个,其中54个为转移癌,转移率为81.8%(54/66)。结论:亚甲蓝染色法检测乳腺癌SLN经济实用,可以较准确地预测腋窝淋巴结的转移状况。

Objective： To study a method which can detect the sentinel lymph nodes （ SLNs）, and to determine the accurate status of axillary by sentinel lymph node biopsy （SLNB） . Methods： SLNs of 81 breast cancer patients were determined by intradermal methyhhionine chloride injection to compare the lymph node metastasis after axillary lymph node dissection （ALND）. All cases were verified by pathology. Results： SLNs were successfully detected in 79 of 8l （97.5%） patients. There were totally 166 SLNs, averagely 2. 1 per each case ; 3 cases false - negative results accounting for 3. 8%, but none false positive results. There were 30 cases of positive SLN in 79 cases accounting for 38.0% ; totally 66 SLNs, there were 54 cases of metastatic carcinoma accounting for 81.8% （54/66） . Conclusion： Intradermal methyhhionine chloride injection is helpful to identify SLNs, which can predict the axillary lymph node status accurately. This method is cheap and can be widely used.