摘要
目的通过荧光剂和美蓝联合注射,进行乳腺癌前哨淋巴结活检(sentinel lymph nodebiop—sy,SLNB),分析其预测腋窝淋巴结状态的应用价值。方法2013年10月至2014年6月接受手术的156例女性乳腺癌患者,分为实验组(n=78)和对照组(n=78),分别以荧光剂联合亚甲蓝和亚甲蓝作为示踪剂实施SLNB活检,快速病理检查。术中进行腋窝淋巴结清扫,结合病理区分前哨淋巴结(sentinel lymphnode,SLN)转移的真阴性、假阴性和真阳性、假阳性。结果荧光剂联合亚甲蓝法检出率为97.44%,成功检出SLN164个,平均每例检出2.10个SLN,准确率97.44%,灵敏度97.44%,假阴性率0%,假阳性0%;亚甲蓝法检出率为89.74%,成功检出SLN139个,平均每例检出1.78个SLN,准确率89.74%,灵敏度89.74%,假阴性率为10.26%,假阳性3.85%。2组平均检出个数和假阴性率差异有统计学意义(P〈0.05),检出率、准确率、灵敏度差异无统计学意义(P〉0.05)。结论荧光剂联合注射亚甲蓝对淋巴结示踪达到良好的效果,具有检出率高、创伤小等优势,有助于判定腋窝分期,准确进行术中腋窝淋巴结的清扫,降低患者术后并发症。
Objective To analyze the value of sentinel lymph node biopsy(SLNB) in predicting axillary lymph node status by injection of fluorescence agent and methylene blue. Methods 156 breast cancer patients receiving surgery from Oct. 2013 to Jun. 2014 were studied and they were randomly divided into the experimental group (n = 78)and the control group( n = 78 ). The fluorescent agent combined with methylene blue and methylene blue were used respectively as tracers for SLNB. Axillary lymph nodes dissection was made during surgery and combined with pathology the status of sentinel lymph node(SLN) metastasis was distinguished between true nega- tive, false negative, true positive, and false positive. Results A total of 164 SLNs were detected by the method of fluorescent agent combined with methylene blue with the detection rate of 97.44%. An average of 2. 10 SLNs were detected for each patient. The accuracy rate was 97.44%, the sensitivity was 97.44%, the false negative rate and the false positive rate was 0% and 0%. A total of 139 SLNs were detected by the method of methylene blue with the detection rate of 89.74%. An average of 1.78 SLNs were detected for each patient. The accuracy rate was 89. 74%, the sensitivity was 89. 74%, the false negative rate and the false positive rate was 10. 26% and 3.85%. There was statistical difference between the two groups in the average detection number and the false negative rate(P 〈 0. 05 )while no statistical difference was found in the detection rate, accuracy, or sensitivity between the two groups (P 〉 0. 05 ). Conclusion Fluorescent agent combined with methylene blue as tracer for lymph nodes has the advantages of higher detection rate and less trauma, which is worth of clinical application.
出处
《中华内分泌外科杂志》
CAS
2015年第4期322-324,共3页
Chinese Journal of Endocrine Surgery
关键词
乳腺癌
前哨淋巴结
荧光剂
亚甲蓝
Breast cancer
Sentinel lymph node
Fluorescence probe
Methylene blue