乳腺癌前哨淋巴结活检80例分析

Clinical analysis of sentinel lymph node biopsy in 80 breast cancer cases

目的:探讨乳腺癌前哨淋巴结活检(sentinel lymph node biopsy,SLNB)的方法和临床应用价值。方法:2003年2月-2008年3月本科共收治80例乳腺癌患者,采取美兰染色SLNB,行前哨淋巴结(SLN)术中冰冻切片,并与术后SLN连续切片及免疫组化检查作比较。结果:69例成功行SLNB,成功率86.3%,术中冰冻切片发现24例SLN癌转移,45例阴性者术后行连续切片及常规免疫组化检查发现5例微转移。结论:美兰染色SLNB成功率较高、安全、价廉,前哨淋巴结状况对乳腺癌腋窝淋巴结有重要预示价值,SLN连续切片联合免疫组化检查,可增加SLN微转移的检出率,减少假阴性率。

AIM： To investigate the application and clinical efficiency of sentinel lymph node biopsy（SLNB） in breast cancer.METHODS： The sentinel lymph nodes（SLNs） of 80 patients with breast cancer were detected by SLNB with intraoperative frozen section and methylene blue staining.The results were compared with serial section and immunohistochemical staining of SLN after operation.RESULTS： 69 of 80 patients were successfully detected by SLNB,with achievement ratio of 86.3%.24 patients were found positive of carcinomatous metastasis by intraoperative frozen section and methylene blue staining,while 45 negative patients were examined by serial section and immunohistochemical staining after operation and found 5 cases with micrometastasis.CONCLUSION： SLNB with methylene blue staining was safe,cheap and had high achievement ratio.The status of SLNs had important prefigurative value about axillary lymph nodes in breast cancer.The application of serial section associated with immunohistochemical staining of SLN could increase the detective rate of metastasis,and reduce the false negative rate.