新辅助化疗对乳腺癌患者行腋窝前哨淋巴结活检术结果的影响研究

Effect of neoadjuvant chemotherapy on axillary sentinel lymph node biopsy in patients with breast cancer

目的研究新辅助化疗(NAC)对乳腺癌患者行腋窝前哨淋巴结活检术(SLNB)结果的影响。方法选取82例乳腺癌患者作为研究对象,其中新辅助化疗后行SLNB为观察组(n=40),未行新辅助化疗直接SLNB为对照组(n=42例),采用亚甲蓝示踪法进行SLNB,统计分析两组患者前哨淋巴结(SLN)的检出率、准确率、假阴性率、灵敏度。结果观察组SLN检出率为90.0%(36/40),SLNB预测腋窝淋巴结状况的准确率、假阴性率、灵敏度分别为94.4%(34/36),11.1%(2/18)和88.9%(16/18);对照组检出率为90.5%(37/42),SLNB预测腋窝淋巴结状况的准确率、假阴性率、灵敏度分别为94.6%(35/37),10.0%(2/20)和90.0%(18/20);两组比较,检出率、准确率、假阴性率、灵敏度方面的差异无统计学意义(P>0.05)。结论新辅助化疗后SLNB临床意义未见明显改变。

Objective To study the effect of neoadjuvant chemotherapy （NAC） on axillary sentinel lymph node biopsy （SLNB） in breast cancer patients. Methods A total of 82 cases of breast cancer patients as the research object, which after neoadjuvant chemotherapy SLNB for the observation group （n=40）, without neoadjuvant chemotherapy directly SLNB as control group （n=42）. SLNB was carried out by the methylene blue tracer, and statistical analysis of two groups of patients with sentinel lymph node （SLN） detection rate, accuracy rate, false negative rate, and sensitivity was carried out. Results In observation group, the positive rate of SLN was 90.0% （36/40）, SLNB in predicting axillary lymph node status of the accuracy rate, false negative rate, sensitivity was 94.4% （34/36）, 11.1% （2/18） and 88.9% （16/18） respectively; In control group, the positive rate of SLN was 90.5% （37/42）, SLNB in predicting axillary lymph node status of the accuracy rate, false negative rate and sensitivity were 94.6% （35/37）, 10.0% （2/20） and 90.0% （18/20）. There was no significant difference in the detection rate, accuracy rate, false negative rate and sensitivity between the two groups （P〉0.05）. Conclusion There was no significant change in the clinical significance of SLNB after neoadjuvant chemotherapy.