45例原发乳腺癌病人前哨淋巴结活检的临床意义初探

Clinical Significance of Sentinal Lymph Node Biopsy for Breast Cancer

目的 :探讨开展乳腺癌前哨淋巴结活检 (sentinellymphnodebiopsy ,SLNB)的必要性、可行性、准确性及临床应用价值 .方法 :对 4 5例临床、B超及钼靶检测腋窝LN阴性的原发乳腺癌患者 ,术中在原发肿瘤周围注射专利蓝进行腋窝淋巴结切除 (SLNB) ,随后行腋窝淋巴结清扫 (ALND) .术中对部分SLN ,术后对全部LN行常规病理检查 .结果 :4 5例患者中 4 1例检测到SLN ,成功率 91 1% ;假阴性率为 2 4 % ,SLNB总的敏感性是 93 3% ,特异性是 96 1% ;总的阳性和阴性预测值分别是 93 3%和 96 1% .结论 :SLNB能够准确的预测腋窝淋巴结的转移情况 。

Objective: To study the necessity, feasibility, accuracy and clinical value of sentinel lymph node biopsy(SLNB) for breast cancer. Methods: Our study enrolled 45 patients with primary breast cancer. Ultrasonographically and mammographically negative axillae. Mapping procedures and SLND were performed using patent blue injected at the primary breast cancer site followed by axillary lymph node dissection (ALND). Sentinel lymph node (SLN) was examined by using frozen sections intraoperatively and all of the axillary nodes were evaluated pathologically (HE) afteroperation. Results: Sentinel nodes were identified in 41(91 1%) of 45 procedures. For 1(2 4%) of 41 cases, the SLN was false-negative. The overall sensitivity of the SLN technique was 93 3%, with a specificity of 96 1%. The overall positive and negative predictive values were 93 3% and 96 1%. Conclusion: SLNB could accurately predict the axillary status of breast cancer patients , improve the accuracy of the axillary staging of breast cancer.