乳腺癌前哨淋巴结活检应用下的腋窝淋巴结处理

Management of axilliary lymph node under the guidance of sentinel lymph node biopsy in patients with breast cancer

目的观察前哨淋巴结活检指导下的乳腺癌腋窝淋巴结处理的效果，探讨前哨淋巴结活检在乳腺癌治疗中的意义。方法回顾性分析了我院自2006年1月-2010年12月106例行SLNB患者的临床资料。结果106例患者中有102例（96．2％）成功进行SLNB。术中冰冻病理SLN阳性60例（58．8％），SLN阴性42例（41．2％）；共检出SLN306枚，每例检出SLN2-8枚，平均3．0枚，检出阳性SLN192枚，阴性114枚。42例SLN阴性未行ALND患者随访6-66个月，中位时间36．5月，未见腋窝淋巴结转移，未见患侧上肢水肿、麻木、感觉异常。结论SLNB能准确预测腋窝淋巴结状态，且较ALND有较少的并发症；但丰富经验的团队、规范的技术操作和充分的告之获得患方的理解是开展SLNB必要的条件。

Objective To investigate the effect of axilliary lymph node management under the guidance of sentinel lymph node biopsy （SLNB） in patients with breast cancer. Methods Clinical data of 106 patients undergoing sentinel lymph node biopsy between January, 2005 and December, 2010 were reviewed. Results 102 patients underwent sentinel lymph node biopsy successfully including 60 patients with positive result and 42 patients with negative result, and 306 sentinel lymph nodes were harvested including 192 positive lymph nodes and 114 negative lymph nodes. 42 patients with negative sentinel lymph node were free of axiliary lymph node dissection and no axililiary lymph node metastasis, edema or paraesthesia of the upper extremity in the affected side was followed up in between 6 and 66 months postoperatively. Conclusion Sentinel lymph nodes biopsy can provide prediction of axiliary lymph node condition and less postoperative complications than axiliary lymph node dissection. However, experienced medical team, standard operation and preoperative sufficient apprehension and consent from patients are the premise of sentinel lymph node biopsy.