亚甲蓝示踪法定位乳腺癌前哨淋巴结的评价

Evaluation of methylene blue method for sentinel lymph node biopsy in breast cancer

目的 评估亚甲蓝在乳腺癌前哨淋巴结活检 (SLNB)中的应用价值。方法 对 10 0例临床分期为T1 2 N0 M0 的乳腺癌患者 ,术中用 1%亚甲蓝注射在原发肿瘤周围进行腋淋巴结定位并前哨淋巴结切除 ;随即行乳腺癌根治或改良根治切除术。全部标本作病理学检查。结果 本组 10 0例患者中 78例发现了前哨淋巴结 (SLN) ,占 78%。发现前哨淋巴结的患者中 40例 (5 1.2 % )有腋窝淋巴结癌转移 ,其中有 3例SLN阴性。用亚甲蓝为示踪剂SLNB的准确率为 96.1% (75 / 78) ,假阴性率为 7.5 % (3/ 40 ) ;SLN对腋窝淋巴结状况预测的敏感性为 92 .5 % (37/ 40 ) ;阳性预测值和阴性预测值分别为 10 0 %和 90 .2 %。结论 亚甲蓝示踪法在探查乳腺癌前哨淋巴结估测癌转移 。

Objective To summarize and evaluate the application of methylene blue for sentinel lymph node biopsy (SLNB) in breast cancer.Methods One hundred cases of breast cancer with T 1?2 N 0M 0 stage were studied.During surgery,radical or modified mastectomy was preceeded following injection of 1% methylene blue around the primary tumor,to locate axillary lymph nodes and resect of sentinel lymph nodes (SLN).The resected specimens were examined.Results SLN was found in 78 of 100 cases (78.0%),in the 78 patients,40 (51.2%) had histologically positive axillary lymph nodes,including 3 patients with negative SLN.The accuracy of SLNB to predict the axillary lymph node status was 96.1% and false negative rate 7.5% (3/40).The sensitivity of methylene blue tracing in this study was 92.5 %(37/40).The positive and negative predictive values were 100% and 90.2%.Conclusion With improvement of technique and accumulation of experience,methylene blue tracing in biopsy of SLN is effective in clinical practices.