腋窝前哨淋巴结活检在原发性乳腺癌患者中的应用价值

Application value of sentinel lymph node biopsy in clinical examination of primary breast cancer with positive axillary node

目的探讨前哨淋巴结活检在临床检查腋窝淋巴结阳性的原发性乳腺癌患者中的应用价值。方法回顾性分析255例临床检查腋窝淋巴结阳性的原发性乳腺癌患者的临床资料,对比临床查体、超声影像学检查、超声影像异常的淋巴结穿刺病理学检查对于腋窝淋巴结状态判断的可靠性。结果 255例乳腺癌患者中,199例(78.0%)经病理学检查证实存在腋窝淋巴结转移。245例(96.1%)在超声检查时发现异常淋巴结;通过超声结合影像异常淋巴结穿刺病理学检查确诊腋窝淋巴结转移172例,占所有腋窝淋巴结转移患者的86.4%。125例临床查体c N1的患者中,18例(14.8%)穿刺病理学检查及前哨淋巴结活检均未见癌转移。结论对于临床检查腋窝淋巴结阳性的原发性乳腺癌患者,特别是穿刺未获得阳性结果者,应行前哨淋巴结活检,以避免不必要的腋窝淋巴结清扫。

Objective To investigate the application value of sentinel lymph node biopsy（ SLNB） in clinical examination of primary breast cancer with positive axillary node. Methods The clinical data of 255 patients with primary breast cancer whose axillary nodes were positive were retrospectively analyzed. The reliability of using clinical physical examination,ultrasound imaging,and ultrasonic imaging abnormalities of lymph node biopsy pathology inspection for judging the axillary lymph node was compared. Results A total of 199（ 78. 0%） of 255 patients were confirmed the presence of axillary lymph node metastases. Totally 245（ 96. 1%） patients had abnormal lymph nodes. 86. 4%（ 172 /199） patients were confirmed metastases by fine-needle aspiration cytology（ FNAC）. During 125 patients with palpable lymph nodes,18（ 14. 8%） patients had negative results in both FNA and SLNB. Conclusion For patients who have primary breast cancer with positive axillary in clinical examination,especially who are not confirmed metastases by FNAC,should receive SLNB to avoid unnecessary axillary lymph node clearance.