104例乳腺癌前哨淋巴结检测和临床分析

104 Cases of Breast Cancer Sentinel Lymph Node Detection and Clinical Analysis

目的 探讨乳腺癌前哨淋巴结活检（SLNB）及前哨淋巴结微转移（SLN MMs）的临床意义。方法 （1）回顾性分析2010~2011年我院乳腺癌行SLNB并腋窝淋巴结清扫（ALND）病例104例,检测SLN灵敏度、特异度、假阴性率。（2）8例SLN阴性、ALN阳性的冰冻剩余石蜡组织行多层连续切片（SS）,检测SLN微转移。结果 （1）SLN的灵敏度为94.55%（52/55）,特异度100%（44/44）,假阴性率5.45%（3/55）。（2）8例SLN SS发现转移3例,1例宏转移,1例微转移（MMs）,1例孤立性肿瘤细胞（ITCs,并且淋巴结被膜外脉管内可见瘤栓）。结论 SLN的灵敏度、特异度高,假阴性率低,可以安全准确地提供腋窝淋巴结分期。SLN SS能提高SLN MMs检出率,从而提高临床分期的准确性,对其后期治疗及预测可能具有指导意义。

Objective To explore the clinical significance of sensitivity lymph node biopsy （ SLNB ） and sensitivity lymph node micrometastases in breast cancer. Methods （ 1 ） A retrospective analysis of 104 breast cancer patients with SLNB and axillary lymph nodes dissection （ALND）, diagnosed and treated in affiliated tumor hospital, xinjiang medical university from 2010 to 2011. （ 2 ） The 8 cases （ SLN-negetive and ALN-positive ） are serially sectioned （ ss ） at a 200 μ m interval and 5 μm thickness, which SLN MMs are analyzed. Results （ 1 ） The sensitivity, specificity, false negative rate of the 104 cases SLN are 94.55% （ 52/55 ）, 100% （ 44/44 ）, 5.45% （ 3/55 ） . （ 2 ） The 3 cases are positive of the 8 cases SLN ss, one is metastases, nne is MM, another is isolated tumor cells （ ITCs ） . Conclusion SLNB in breast cancer have higher sensitivity and specificity, lower false negative rate. SLN can predict the status of ALN, to reducing the incidence of postoperative complications. The SLN SS can improve the rate of detection SLN MMs, which can improve the accuracy of clinical staging and will be the guidance for post-treatment.