乳腺癌前哨淋巴结活检术学习曲线研究

Reserach of learing curve of sentinel lymph node biopsy in breast cancer

目的探讨乳腺外科医生前哨淋巴结活检术(SLNB)的学习曲线,分析影响学习曲线的因素,以便SLNB在临床上广泛开展。方法以40例临床体检腋窝淋巴结(ALN)阴性,可手术乳腺癌患者作为研究对象,所有患者均单独采用美蓝染色剂作为前哨淋巴结(sentinel lymphnode,SLN)示踪剂,常规行SLNB活检和ALND(腋淋巴结清扫术)。结果本组共有38例患者找到SLN,成功率为95.0%,其中病理报告SLN癌性转移者11例,无转移27例,1例SLN冰冻阴性,常规病理阳性,假阴性率为9.1%(1/11)。SLNB与ALND转移检测比较效果相一致,准确率高,统计无差异性。结论应用美蓝进行SLNB能替代ALND成为临床腋淋巴结阴性早期乳腺癌患者的标准处理模式。

Objective To evaluate the learning curve and the efficacy of sentinel lymph node biopsy（SLNB）by the breast surgeon in the existing medical conditions.Methods Forty cases of breast tumor without axillary lymph node（ALN）by palpation were enrolled in this study.And using the methylene blue as the tracer agent,All patients were treated by segment resection plus axillary lymph node dissection（ALND）.Biopsies of sentinel lymph nodes and axillary lymph nodes were taken in all patients.Results The SLN were detected in 38 patients,11 cases has metasis and 27 cases has no metasis,the accurate rate of SLNB was 95%,1 case was negative detected by the rapid pathology but positive by the routine pathology,its false negative rate was 9.09%（1/11）.There was no significant difference between the effect of detection of metastasis by sentinel lymph node or axillary lymph node biopsy.Conclusion The SLN of the breast cancer can accurately reflect the status of the patients with armpit lymph node,SLNB replacing ALND will be a standard handler for the early stage breast cancer without ALN by palpation.