乳腺癌新辅助化疗后前哨淋巴结活检的可行性研究

Feasibility of sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer

目的探讨新辅助化疗(NAC)后前哨淋巴结活检(SLNB)对腋窝淋巴结分期的预测价值。方法选取2017年1月~2018年3月我院收治的新发乳腺肿瘤患者31例作为研究对象,采用随机数字表法将其分为对照组(16例)、实验组(15例)。实验组先行NAC后进行SLNB,随后进行乳腺癌改良根治术+腋窝淋巴结清扫术;对照组先行SLNB后行NAC,之后进行乳腺癌改良根治术+腋窝淋巴结清扫术。通过检出淋巴结的病理情况,比较两组的检出率、假阴性率、准确度、阴性灵敏度及前哨淋巴结转移率。结果两组患者的假阴性率、准确度、阴性灵敏度比较,差异均无统计学意义(P>0.05);实验组患者的前哨淋巴结转移率、检出率均低于对照组,差异有统计学意义(P<0.05)。结论新辅助化疗后前哨淋巴结活检同样可以预测腋窝淋巴结的转移情况,但对于远期预后仍需进一步研究。

Objective To investigate the predictive value of sentinel lymph node biopsy（SLNB） for axillary lymph node staging after neoadjuvant chemotherapy（NAC）. Methods Thirty-one new breast cancer patients admitted to our hospital from January 2017 to March 2018 were selected as the research objects, and were divided into control group（16 cases）and experimental group（15 cases） by random number table method. After NAC, SLNB was performed in the experimental group, followed by modified radical mastectomy plus axillary lymph node dissection. The control group underwent NAC after SLNB, followed by modified radical mastectomy plus axillary lymph node dissection. The detection rate, false negative rate, accuracy, negative sensitivity and sentinel lymph node metastasis rate of the two groups were compared through the pathological conditions of the detected lymph nodes. Results There was no statistically significant difference in false negative rate, accuracy and negative sensitivity between the two types of patients（P〉0.05）. The detection rate of sentinel lymph node metastasis in the experimental group was lower than that in the control group, and the difference was statistically significant（P 0.05）. Conclusion Sentinel lymph node biopsy after neoadjuvant chemotherapy can also predict axillary lymph node metastasis, but further study is needed for long-term prognosis.