前哨淋巴结阳性患者腋下转移淋巴结分布规律的临床研究

Distribution of Metastatic Axillary Lymph Nodes in Patients with Positive Sentinel Lymph Nodes

目的研究前哨淋巴结阳性患者施行腋淋巴结清扫应用新的腋下组分区法时转移淋巴结的分布规律.方法选取83例前哨淋巴结阳性的乳腺癌患者常规施行腋窝淋巴结清除术,术后将腋下组淋巴结严格按新设定的分组标准分成A,B,C,D四区,并将各区淋巴结分别装袋送术后病理,研究不同前哨淋巴结阳性个数的乳腺癌患者每个区域检出和转移淋巴结的个数及分布规律.结果各区淋巴结检出数和阳性率均存在存在明显差异,D区B区检出淋巴结最多,分别占总数的36.1%(612/1 693)和29.1%(492/1 693),阳性率最高的为B区(37,8%),D区最低(0.5%).结论前哨淋巴结阳性患者施行腋淋巴结清扫转移淋巴结最常见的区域为B区(阳性率37.8%)和A区(阳性率11.5%),也就是胸背脉管束内侧区域,出现最少的区域为D区(阳性率0.49%),而在前哨淋巴结2枚以下阳性组D区未发现转移淋巴结.

Objective To research the patterns of metastatic axillary lymph nodes in the patients with positive sentinel lymph nodes when we use the new grouping method. Method 83 breast cancer patients with positive sentinel lymph nodes suffered axillary lymph node dissection （AIND） were chosed, the axillary lymph nodes were divided into 4 groups, A, B, C and D according to new grouping guide, according to postoperation pathology, we research the patterns and the numbers of metastatic axillary lymph nodes in every region in the patients with different numbers of positive sentinel lymph nodes. Result There are Significant difference in the detection lymph nodes numbers and the positive rates in different regions, the detection lymph nodes in D and B were the most ,36. 1% （612/1 693 ）and 29. 1% （492/1 693 ）of the total, and the highest positive rate region was B（37.8% ） ,the lowest was D（0. 5% ）. Conclusion The most metastatic axillary lymph nodesin the axillary lymph node dissection in patients with positive sentinel lymph node was in B （positive rate 37.8 % ） and A （ positive rate 11.5 % ）, located in the medial of Thoracodosal Artery, the number in D was the least （ positive rate 0. 49 % ）, and there are no metastatic lymph node in D in the patients with positive sentinel lymph nodes were under 2.