乳腺癌前哨淋巴结临床病理的研究

Clinicopathological Study of Sentinel Lymph Nodes in Breast Carcinoma

目的 探讨乳腺癌前哨淋巴结能否准确反映腋窝淋巴结转移情况。方法 对 36例早期乳腺癌 ,常规HE染色检测腋窝淋巴结 ,对HE染色阴性的前哨淋巴结及所属非前哨淋巴结 ,连续切片、免疫组化染色 ,检测其肿瘤的转移情况。结果 常规病理检测 ,36例中 ,10例腋窝有转移 ,其中 2例仅前哨淋巴结有肿瘤转移。连续切片、免疫组化检测 2 6例阴性的前哨淋巴结共 6 1枚 ,非前哨淋巴结 40 6枚 ,2例 (2枚 )仅前哨淋巴结发现有肿瘤转移 ,余 2 4例前哨淋巴结及非前哨淋巴结均无肿瘤转移 ,HE染色的检测阴性的前哨淋巴结患者假阴性率为 7.7% (2 / 2 6 )。

Objective To test whether the histology of the sentinel lymph node(SLN) can accurately predict the histology of the rest of the axillary lymph nodes(ALNs).Methods Thirty six patients with early breast carcinoma were studied.All lymph nodes were subjected to routine histology(hematoxylin and eosin,HE).Additional sections from HE negative SLN and NSLN were examined for the presence of occult metastatic carcinoma by serial sectioning(SS) and cytokeratin immunohistochemical stains(IHC).Results Ten of the 36 patients were found to have metastasis in SLNs by HE.Applying SS and IHC to the 61 tumor free SLNs in other 26 patients showed additional 2 tumor involved nodes for a conversion rate of 7.7%(2/26).The 406 NSLNs in the 26 patients examined by SS and IHC were not identified any additional metastases.Conclusion The status of the SLNs can accurately predict total axillary status in early breast carcinoma.