新辅助化疗后行乳腺癌前哨淋巴结活检意义分析

Analysis on the significance of sentinel lymph node biopsy in breast cancer after neoadjuvant chemotherapy

目的探讨新辅助化疗后行乳腺癌前哨淋巴结活检意义.方法选取2017年1月~2018年12月我院治疗的110例乳腺癌患者为研究对象,随机分为实验组(51例)应用新辅助化疗后行前哨淋巴结活检,对照组(59例)直接应用前哨淋巴结活检,观察比较两组准确率、检出率、灵敏度、假阴性率差异,分析新辅助化疗前哨淋巴结活检检出率与临床病理关系.结果实验组前哨淋巴结检出率、准确率、灵敏度、假阴性率分别为92.16%、89.36%、92.00%、4.26%,与对照组(91.53%、87.04%、89.66%、5.56%)比较,差异无统计学意义(P>0.05);实验组T2期患者前哨淋巴结检出率(97.43%)较T3期患者(75.00%)高,差异有统计学意义(P<0.05).肿瘤外侧区前哨淋巴结检出率93.75%,内测区和中央区前哨淋巴结检出率为89.47%,不同区域检出率比较,差异无统计学意义(P>0.05).结论乳腺癌患者在新辅助化疗后行前哨淋巴结活检可预测腋窝淋巴结病理学状态,临床应用价值高.

Objective To investigate the significance of sentinel lymph node biopsy in breast cancer after neoadjuvant chemotherapy. Methods A total of 110 patients with breast cancer who were treated in our hospital from January 2017 to December 2018 were selected as study subjects. They were randomly assigned to the experimental group(n=51), which were given sentinel lymph node biopsy after neoadjuvant chemotherapy, and the control group(59 cases), which were directly given sentinel lymph node biopsy. The difference in the accuracy, detection rate, sensitivity and false negative rate was observed and compared between the two groups. The relationship between the detection rate of sentinel lymph node biopsy after neoadjuvant chemotherapy and the clinical pathology was analyzed. Results The detection rate, accuracy, sensitivity and false negative rate of sentinel lymph nodes in the experimental group were 92.16%, 89.36%, 92.00% and 4.26%, respectively. Compared with the control group(91.53%, 87.04%, 89.66%, 5.56%), the differences were not statistically significant(P>0.05);the detection rate of sentinel lymph nodes in the T2 stage patients in the experimental group(97.43%) was higher than that in the T3 stage patients (75.00%), and the difference was statistically significant(P<0.05). The detection rate of sentinel lymph nodes in the lateral area of the tumor was 93.75%, and the detection rate of sentinel lymph nodes in the internal and central areas was 89.47%. There was no statistically significant difference in the detection rate of different areas (P>0.05). Conclusion Sentinel lymph node biopsy in the patients with breast cancer after neoadjuvant chemotherapy can predict the pathological state of axillary lymph nodes and has a high clinical application value.