亚甲蓝联合彩超在早期乳腺癌腋前哨淋巴结活检替代腋淋巴结清扫手术中的应用研究

Methylene Blue Combined with Sonography for SLNB Replacing ALND in the Operation fro Early-stage Breast Cancer

[目的]探讨亚甲蓝联合彩超在早期乳腺癌腋前哨淋巴结活检替代腋淋巴结清扫手术中应用的可行性。[方法]收集浙江省肿瘤医院经病理证实的、临床淋巴结触诊阴性的早期乳腺癌148例,比较亚甲蓝介导的前哨淋巴结与彩超标记引流淋巴结位置的一致性,比较术中快速病理与术前彩超评估联合术中快速病理对于淋巴结性质判断的准确性。[结果]亚甲蓝介导的前哨淋巴结位置与彩超标记引流淋巴结区域位置的一致性达100%(134/134)。术中快速病理的准确率为90.30%(121/134),彩超联合术中快速病理的准确率为93.2%(138/148),但两者比较差异无统计学意义(χ2=0.814,P=0.367)。[结论 ]亚甲蓝介导SLNB具有较好的准确率,彩超应用对于准确定位前哨淋巴结、判断淋巴结的性质提供了帮助。

[Purpose] To explore the feasibility of methylene blue combined with sonography for axillary sentinel lymph node biopsy（SLNB） replacing axillary lymph node dissection（ALND） in the operation for early stage breast cancer. [Methods] A total of 148 patients with breast cancer pathology proven with clinical palpation negative lymph node were enrolled. The consistency was compared between lymph node location with sonography markers and that with methylene blue me-diated. The evaluation accuracy was compared between intraoperative frozen section and preopera-tive sonography combined with intraoperative frozen section. [Results] The consistency of lymph node location marked by sonography and by methylene blue was 100%（134/134）. The accuracy rate of intraoperative frozen section was 90.30%（121/134）,and that of sonography combined with intraoperative frozen section was 93.2%（138/148）,with no statistical significance（χ2=0.814,P=0.367）.[Conclusions] The accuracy is high in induced methylene blue SLNB. The application of sonogra-phy is helpful for accurate positioning and evaluation for SLB.