原发性乳腺癌超声影像异常腋窝淋巴结穿刺病理学检查的临床应用

Role of ultrasound-guided needle biopsy of ultrasonographic abnormal axillary lymph nodes in patients with breast cancer

目的探讨针对超声影像异常的腋窝淋巴结进行穿刺病理学检查的临床意义。方法回顾性分析395例原发性乳腺癌超声影像异常腋窝淋巴结的穿刺病理学检查结果及其临床资料。结果277例（70．1％）经穿刺病理学检查诊断淋巴结转移，其中47．8％（65／136）的N0期病例病理确诊淋巴结转移。62例穿刺病理学检查阴性乳腺癌随后接受前哨淋巴结活检或腋窝淋巴结清扫术，42例确诊淋巴结阴性。经过新辅助化疗，转移淋巴结的病理完全缓解率为32．3％（62／192）。结论腋窝淋巴结超声影像结合穿刺病理学检查可用于原发性乳腺癌治疗前的基线检查。

Objective To evaluate the utility of ultrasound （US）-guided needle biopsy of ultrasonographic abnormal axillary lymph nodes in the patients with breast cancer. Methods The pathological results of US-guided needle biopsy and clinical data of 395 primary breast cancer patients with uhrasonographic abnormal axillary nodes, all female, aged 24 -83, were analyzed retrospectively. Results Node metastasis were detected in 277 （70.1%）cases by mean of ultrasound-guided needle biopsy. Among 136 patients with clinical No breast cancer, 65 （47.8%） were proved node positive. Sixty-two patients were diagnosed as pathologically negative by needle biopsy and underwent sentinel lymph node biopsy or axillary lymph node clearance, and pathological examination showed negative axillary lymph node negative. The complete pathological complete remission rate of the metastatic lymph nodes after new adjuvant chemotherapy was 32.3% （62/192）. Conclusion Uhrasonographic examination of axilla combined with ultrasoundguided needle biopsy of suspicious axillary node is valuable in primary breast cancer treatment.