乳腺癌前哨淋巴结活检中几个问题的探讨

Several questions in Sentinal lymph node biopsy in breast cancer patients

前哨淋巴结活检替代腋窝淋巴结清扫的可行性研究已经有大量的文章报道，也已经达成共识，但是，鉴于临床上还存在一定的假阴性率，这一术式还有很多值得商讨的细节问题需要进一步研究：为了减少假阴性的比例应当取多少个前哨淋巴结才能将假阴性降到最低点？前哨淋巴结阳性病例腋窝淋巴结是否全部需要清扫？手术后发现前哨淋巴结微小转移灶的如何进一步处理等。本文就以上问题作一综述。

There are a lot of feasibility studies,using sentinel lymph node biopsy SLNB instead of Alex lymph node dissection （ALND） , having got a consensus that SLNB is a safe and useful method in the treatment of breast cancer. But in clinical practice, there are much false negative rate （FNR） which need to be carefully dealt with for SLNB. In order to diminish the FNR, how many nodes should be the perfect number to lower the FNR？ If positive detection was found in the SLN, should ALND always be needed？ And when micro metastasis was found in the post operation HE staining？ Does it need further treatment？ We make a review to discuss those matters.