乳腺癌哨兵淋巴结微转移的检测及临床意义

The Clinical Significance of Micrometastasis Detection in Sentinel Lymph Node of Breast Carcinoma

目的 探讨乳腺癌患者哨兵淋巴结 (sentinellymphnode ,SLN )中微转移的检测方法及临床意义。 方法 对 5 0例乳腺癌患者用美蓝染色法 ,寻找到腋窝SLN ,予以切除并行常规HE染色病检 ,其阴性SLN以 2 5 0 μm间距行连续切片 (serialsection ,SS)及以细胞角蛋白 19(cytokeratin19,CK19)为单抗行免疫组化 (immunohistochemical,IHC)检测 ,比较三种方法检测SLN的结果。结果 5 0例中发现SLN 45例 ,常规病检 16例SLN阳性 ,2 9例SLN阴性者经采用SS和IHC法检测 ,分别检出SLN中有微转移灶 7例和 6例 ,阳性检出率分别提高 15 .5 5 %和 13 .3 3 %。结论 SS和IHC法可检出常规HE染色阴性SLN中的微转移灶 ,提高SLN的阳性检出率 ,降低假阴性率。

Objective To study the detection methods of micrometastasis in sentinel lymph nodes (SLN) and their clinical significance. [WT5”HZ]Methods [WT5”BZ]Fifty women with breast carcinoma were included. SLN in fifty breast carcinoma was identified by using methylene blue staining to detect and remove them for routine hematoxylin and eosin stain and histological exam. All negative SLNs were examined by serial section (SS) with the section interval of 250 μm and HE stain for microscopic examination and immunohistochemical (IHC) exam was performed with CK19 monoclonal antibody. Then the above three detection methods were analyzed. All patients had axillary lymph node dissection (ALND),and all none sentinel lymph nodes (NSLN) were examined by H&E staining.[WT5”HZ]Results [WT5”BZ]The SLNs were identified in 45 of 50 patients with a detection rate of 90%. Sixteen SLNs were found positive with routine histological exam, the positive detecting rate was 35.56%, while the other 29 negative SLNs were found 7 and 6 cases of micrometastasis using SS and IHC methods,therefore the positive detecting rate was increased by 15.55% and 13.33%, respectively.[WT5”HZ]Conclusion [WT5”BZ] SS and IHC methods could detect the micrometastasis in negative SLN with routinely histological exam, increasing the positive detecting rate and decreasing the false negative rate. [WT5”HZ]