前哨淋巴结阴性患者补充低位腋淋巴结清扫的临床研究

Clinical Research of Complementary Low Level Axillary Lymph Node Dissection for Patients with Negative Sentinel Lymph Node

目的:研究前哨淋巴结假阴性患者腋窝阳性淋巴结的分布情况,在腋淋巴结清扫和替代腋淋巴结清扫术以外,探寻一种既可保留腋窝功能,又可不遗漏腋窝阳性淋巴结的新术式的可能性。方法:选取80例前哨淋巴结阴性患者同时行腋淋巴结清扫,将腋窝标本以肋间臂神经最上支为标志分成腋上下两区,并分别病检。结果:术后病理证实前哨淋巴结假阴性5例,腋窝阳性淋巴结9枚,均位于腋下区。结论:本研究显示前哨淋巴结假阴性遗漏的腋窝阳性淋巴结均位于腋下区,对前哨淋巴结阴性患者补充施行低位腋淋巴结清扫,既可保留肋间臂神经在内的腋窝功能,又可全部清除前哨淋巴结假阴性遗漏的腋窝阳性淋巴结。

Objective： To study the distribution of positive axillary lymph node（LN） of the breast cancer patients with false negative （FN） sentinel lymph node（SLN） and seek the possibility of a new operating type which could reserve the axillary functions but could not omit positive LN beyond the axillary lymph node dissection（ALND）and SLN.Method： A total of 80 breast cancer patients with negative SLN were performed ALND simultaneously. Axillary specimens were divided into two sections of the upper and the lower according to the highest branch of nervi intercostobrachiales, and were taken for pathological examination respectively.Result：Five cases were proved to be FN SLN by pathology after operation. The total of 9 positive LN were located in the lower section of axilla.Conclusion：This study demonstrated that the positive LN omittance in patients with FN SLN are all located in lower section of axilla, and can be completely remove by complementary low level ALND which can preserve the axillary functions including nervi intercostobrachiales.