哨兵淋巴结活检术在早期乳腺癌中的临床应用

Clinical Application of Sentinel Lymph Node Biopsy in Early Breast Cancer Patients

目的探讨哨兵淋巴结活检术(SLNB)在早期乳腺癌中的应用,并评价其准确性及可行性。方法对我院2003年5月至2006年11月期间收治的136例早期乳腺癌病例在行乳腺癌手术前均进行SLNB,即乳晕边缘皮下或肿瘤周围皮内-皮下局部注射美蓝注射液,根据蓝染淋巴管寻找哨兵淋巴结(SLN)并摘除,送快速病理检查,根据SLN结果决定是否行腋窝淋巴结清扫(ALND),SLN阴性即免ALND。结果136例患者均发现SLN,检出率100%,假阳性率0,免ALND病例术后随访2～5年半均未发现复发、再发或转移,推测假阴性率为0。结论应用美蓝示踪定位SLNB,能准确地反映腋窝淋巴结状况,SLNB是早期乳腺癌治疗中的实用技术,能在早期乳腺癌治疗中取代ALND。

Objective To evaluate the accuracy and feasibility of sentinel lymph node biopsy （SLNB） in the early breast cancer. Methods 136 cases of early breast cancer patients from May 2003 to November 2006 in our hospital were performed with SLNB before operation. The methylene blue injection was induced by intracutaneous or subcutaneous injection at the site of the primary breast cancer or breast halo, to find the sentinel lymph node （SLN） and extirpate them; all SLN received rapid pathologic examination. The negative SLN should be exempt from axillary lymph node dissection （ALND）. Results All patients found SLN, the positive rate was 100%, and the false positive rate was 0. All patients were exempt from ALND, the postoperative follow-up was 2 to 5 years and 6 months, no recurrence, revival and tumor metastasis were found so the false negative rate was 0. Conclusion Our study indicates that intraoprative lymphatic mapping using methylene blue and SLNB can accurately predict the lymph node status. SLNB is practical and easy to master, and it can replace ALND for early breast cancer patients.