常规检查淋巴结转移阴性之乳腺癌腋窝组织再连续切片检查的研究

Serial Section Study of Axillary Tissues Negative on Routine Section for Lymphnode Metastases of Breast Cancer

本文对天津市人民医院50例浸润性非特殊型乳腺癌根治术后随访5年以上,并常规病理检查腋窝淋巴结阴性的腋窝组织进行再连续切片检查。在50例中,发现10例的腋窝淋巴结有转移,占20％。以淋巴结计,在全组1,002个淋巴结中,有12个发现阳性,占1.2％。所发现受累淋巴结多为被膜内淋巴管或边缘窦癌栓,少数为淋巴结实质内转移,未侵及结外。此50例中腋淋巴结阳性和阴性的患者,在5年存活率方面无明显差别(P>0.05),但术后血行转移较多见于阴性病例。原发癌大小、国际临床期别、腋淋巴结的临床判断情况、肿瘤的组织学类型及淋巴结的免疫形态学改变等,在阴、阳两组之间均无明显差别(P>0.05)。

The axillary tissues of 50 cases with invasive breast cancer of nonspecific type tSat had been followed-up for more than 5 years following radical mastectomy and re- ported negative for axillary lymphnode metastases on routine patnological examina- tions were studied again with serial sections. In 10 of these cases the lymph nodes were found to be involved with foci of cancer cells. Of altogether 1002 lymph nodes collected from the 50 specimens, 12 lymphnodes were involved with metastases. Most of the metastases were located in peripheral sinus or capsular lymphatic spaces of the lymhnodes. Only few metastatic foci were found in the medulla. There was no statis- tically significant difference in survival rates between the patients with and without occult metastases (P>0.05), but blood borne metastasis was more frequent in pa- tients without occult metastases. There was also no significant difference between the two groups as to size of primary tumors, clinical staging, clinical estimation of the status of axillary lymphnodes, histological types of the primary tumor and the immu- nological manifestation in the lymph nodes (P>0.05).