术前活检与术中快速冷冻病理检查诊断早期乳腺癌前哨淋巴结转移的价值研究

Clinical study of sentinel lymph node preoperative biopsy in early breast cancer

目的分析术前活检和术中快速冷冻病理检查在乳腺癌前哨淋巴结假阴性诊断中的差异。方法选取2014年12月—2018年7月哈励逊国际和平医院住院的有乳腺癌前哨淋巴结转移并行腋窝淋巴结清扫术患者150例,分为术前活检组和术中冷冻组。依据术前穿刺、术中冷冻和术后石蜡切片病理结果,对术前活检组患者术前、术后病理一致性(术前活检假阴性率)和术中冷冻组术中、术后病理一致性(术中检测假阴性率)进行统计学分析。结果两组不同年龄、肿瘤直径患者的病理一致率比较,差异无统计学意义(P>0.05)。术前活检组石蜡病理和术前穿刺活检病理的一致率较术中冷冻组高(P<0.05)。术前活检组假阴性率较术中冷冻组低(P<0.05)。结论术前活检在诊断乳腺癌前哨淋巴结转移准确性上优于术中冷冻病理诊断,对治疗方案的优化也具有指导价值。

Objective To investigate and analyze the difference of accuracy between preoperative puncture biopsy and intraoperative frozen pathology in the diagnosis of false negative for sentinel lymph nodes in breast cancer.Methods Retrospective analysis was performed on 116 patients.According to the pathological results,the pathological consistency between the observation group and the control group was statistically analyzed.Results There was no statistically significant difference in the consistent rate of different pathological age groups and tumor size groups between the preoperative biopsy group and the intraoperative frozen group(P>0.05).The consistency rate of preoperative biopsy group was higher than that of intraoperative frozen group(P<0.05).The false-negative rate was lower in preoperative biopsy group than in intraoperative frozen group(P<0.05).Conclusion Preoperative puncture biopsy is more accurate than intraoperative frozen pathology in the diagnosis,and has guiding value for the optimization of treatment scheme.