^(99m)锝硫胶体联合美蓝在乳腺癌前哨淋巴结活检中的应用价值

The bignificance of ^(99m)Tc-SC combined methylere method in sentinel lymph node biopsy of breast cancer

目的探讨锝-99m硫胶体(99mTc-SC)联合美蓝在早期乳腺癌前哨淋巴结活检(SLNB)中的可行性、准确性及临床应用价值。方法采用99mTc-SC联合美蓝对68例T1-2N0M0乳腺癌患者进行SLNB,将切除的前哨淋巴结(SLN)行病理检查了解其符合率,探讨联合法在早期乳腺癌SLNB中的临床应用价值。结果成功确定患者SLN 67例,1例术前单光子发射型计算机断层扫描(SPECT)未显影,10例SLN病理检测阳性并行腋窝淋巴结清扫(ALND),99mTc-SC灵敏度为81.8%,准确性为97.1%,假阴性率为18.2%。美蓝法灵敏度为72.7%,准确性为95.6%,假阴性率为27.3%。联合法灵敏度为90.9%,准确性为98.5%,假阴性率为9.1%。假阳性率为0。结论99mTc-SC联合美蓝检测法可明显降低早期乳腺癌SLNB的假阴性率。

Objective To study the feasibility,accuracy and clinical applied value of sentinel lymph node biopsy（SLNB） in early breast cancer.Methods In 68 cases T1-2N0M0 stage of breast cancer,sentinel lymph nodes identified by 99mTc-sulfur colloid（99m Tc-SC） combining methylene blue were excised for biopsy.SLN was examined pathologically to acquaint the conformance rate and the clinical value of the combination approach in SLNB of early breat cancer.Results SLN was identified in 67 cases,one case was failure examed by SPECT,in 10 cases axillary lymph node dissection had performed because of the SLNB positive.the sensitivity rate of 99mTc-SC and methylene blue method was 81.8% and 72.7%,respectively.the accuracy rate of 99mTc-SC and methylene blue method was 97.1% and 95.6%,respectively.the false negative rate of 99m Tc-SC and methylene blue method was 18.2% and 27.3%,respectively.The sensitivi-ty rate of combination method was 90.9%,and the accuracy rate was 98.5%,the false negative rate was 9.1% and the false positive rate was zero.Conclusion 99mTc-SC combining methylene blue bviously decreased the false negative rate of SLNB in early breast cancer.