前哨淋巴结活检术在乳腺癌手术治疗中的应用

Clinical application of sentinel lymph node biopsy in breast cancer operation

目的 探讨乳晕下亚甲蓝法前哨淋巴结活检术（SLNB）用于乳腺癌手术治疗的可行性及其对腋窝淋巴结分期的预测情况.方法 回顾性分析2009年7月至2012年7月北京丰台医院普外科所实施的60例行SLNB患者的病历资料.60例患者均于患侧乳晕皮下注射1%亚甲蓝2 ml（分4象限注射,每点注射0.5 ml）,并行腋窝淋巴结清扫.结果 60例乳腺癌术中行SLNB病例中57例发现紧急的SLNB,检出率为95.0%.病理检查者发现28例腋窝淋巴结有转移,32例无转移.前哨淋巴结与腋窝淋巴结完全符合者54例,保受阴性者3例.SLNB的准确率为94.7%（54/57）,灵敏度为89.3%（25/28）,假阴性率为10.7%（3/28）.前哨淋巴结检出率与年龄、肿瘤位置、病理类型、雌激素受体无关（P〉0.05）.结论 乳晕下亚甲蓝法SLNB能准确地预测乳腺癌腋窝淋巴结的转移状态.

Objective To evaluate the feasibility of sentinel lymph node biopsy（SLNB） by using subareolar injection of methylene blue in breast cancer and predict axillary lymph node staging. Methods A retrospective study was conducted to analyze 60 cases of breast cancer＆#39;s sentinel lymph node biopsy on the consent of patients in Beijing Fengtai hospital from July 2009 to July 2012. All 60 cases were using methylene blue dye areola injections in subareolar. Axillary lymph node dissection（ALND） in all cases. Results Of 60 cases, 57 patients＆#39; sentinel lymph nodes were detected successfully in all 60 cases.Only 3 cases were not detected and 3 periods negative; the detection rate was 95.0%（57/60）; the accuracy rate was 94.7%（54/57）; the sensitivity was 89.3%（25/28）; the false negative rate was 10.7%（3/28）. Age, location of tumor, histological type and estrogen receptor status were not associated with intraoperative detection rate of SLN（P〉0.05）. Conclusion Sentinel lymph node biopsy can accurately predict the axillary lymph nodes of breast cancer.