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乳腺癌新辅助化疗后前哨淋巴结活检术的研究进展 被引量:10
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作者 张摇 马力 《中国肿瘤临床》 CAS CSCD 北大核心 2019年第21期1135-1138,共4页
新辅助化疗(neoadjuvant chemotherapy,NAC)为乳腺癌患者的临床分期降期带来可能,使不可手术变为可手术,不可保乳变为可保乳。前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)极大降低了早期乳腺癌患者的腋窝淋巴结清扫(axillary ly... 新辅助化疗(neoadjuvant chemotherapy,NAC)为乳腺癌患者的临床分期降期带来可能,使不可手术变为可手术,不可保乳变为可保乳。前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)极大降低了早期乳腺癌患者的腋窝淋巴结清扫(axillary lymph node dissection,ALND)率。目前,由于检出率较低而假阴性率较高,NAC后乳腺癌患者能否采用SLNB方法评估腋窝淋巴结状态仍有争议。本文将针对NAC后解决SLNB检出率低和假阴性率高的方法以及处理腋窝淋巴结等方面进行综述。 展开更多
关键词 乳腺癌 新辅助化疗前 哨淋巴结活检术
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前哨淋巴结活检术在乳腺癌保乳手术治疗中的临床应用与价值 被引量:2
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作者 徐前 倪启超 《交通医学》 2018年第1期33-36,共4页
保乳手术逐渐成为乳腺癌手术治疗的首选方法。因其在保证乳腺癌治疗效果的同时,减少了患者的手术时间、手术伤害,减轻患者的心理压力,促进了术后康复。腋窝淋巴结分级是评价乳腺癌最有力的预后因素之一。保乳的同时施行前哨淋巴结活检术... 保乳手术逐渐成为乳腺癌手术治疗的首选方法。因其在保证乳腺癌治疗效果的同时,减少了患者的手术时间、手术伤害,减轻患者的心理压力,促进了术后康复。腋窝淋巴结分级是评价乳腺癌最有力的预后因素之一。保乳的同时施行前哨淋巴结活检术,可以更精细、微创的检测腋窝淋巴结情况,避免对腋窝淋巴结阴性患者行腋窝淋巴结清扫,减少了传统腋窝清扫的诸多术后并发症。具有创伤小、术后并发症少、住院时间短等许多优点,提高了乳腺癌患者手术治疗后的生活品质。 展开更多
关键词 乳腺癌 保乳手术 哨淋巴结活检术
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新辅助化疗后乳腺癌患者前哨淋巴结活检病理学变化情况以及对预后的影响研究 被引量:2
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作者 杨金喆 杨文涛 朱敬军 《重庆医学》 CAS 2019年第S02期324-326,共3页
目的探讨新辅助化疗后乳腺癌患者前哨淋巴结活检病理学变化情况以及对预后的影响。方法选取2016年1月至2018年12月该院接收的126例乳腺癌患者作为研究的对象,依据是否需进行新辅助化疗方案分为研究组(76例)与对照组(50例)。对照组患者... 目的探讨新辅助化疗后乳腺癌患者前哨淋巴结活检病理学变化情况以及对预后的影响。方法选取2016年1月至2018年12月该院接收的126例乳腺癌患者作为研究的对象,依据是否需进行新辅助化疗方案分为研究组(76例)与对照组(50例)。对照组患者在常规化疗的基础上进行腋窝淋巴结清扫术,研究组采用新辅助化疗方案后进行前哨淋巴结活检术,比较两组患者病理学检查结果,以及研究组患者在实施新化疗方案后SLN的检出率、真阳性率以及假阴性率的比较。结果研究组的76例乳腺癌患者中69例显示腋淋巴结,7例未能显示淋巴结,检出率为90.7%,对照组患者中47例显示腋淋巴结,3例未显示淋巴结,检出率为94.0%,两组患者的检出率无显著差异(P>0.05);两组患者的漏诊率、误诊率以及正确率无显著差异(P>0.05);乳腺癌患者在实施新辅助化疗后SLN的检出率、真阳性及假阴性率与患者的肿瘤分期具有相关性,Ⅲa期乳腺癌患者的检出率及其阳性率高于Ⅲb期(P<0.05)。结论对乳腺癌患者采用新辅助化疗方案治疗后进行前哨淋巴结活检,有利于提升患者的检出率,利于患者病情的缓解,对患者预后有积极的促进作用,利于在临床应用及治疗。 展开更多
关键词 新辅助化疗 乳腺癌 哨淋巴结 活检 预后
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进展期胃癌根治术中二级前哨淋巴结技术的应用 被引量:4
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作者 费挺 余勤 齐长磊 《中华胃肠外科杂志》 CAS CSCD 北大核心 2016年第10期1184-1186,共3页
目的探讨二级前哨淋巴结(SSLN)技术在进展期胃癌(AGC)根治术中应用的可行性及其临床意义。方法回顾性分析2013年1月至2015年12月宁波大学医学院附属医院收治的102例进展期胃窦部癌患者临床资料。分析SSLN转移检出情况与肿瘤大小、... 目的探讨二级前哨淋巴结(SSLN)技术在进展期胃癌(AGC)根治术中应用的可行性及其临床意义。方法回顾性分析2013年1月至2015年12月宁波大学医学院附属医院收治的102例进展期胃窦部癌患者临床资料。分析SSLN转移检出情况与肿瘤大小、浸润深度和分化程度的关系。结果本组102例患者中80例(78.4%)术中检出SSLN,SSLN阳性者占SSLN检出者的80.0%(64/80)。44例No.5淋巴结癌转移患者中,34例(77.3%)检出SSLN;58例No.6淋巴结癌转移患者中,46例(79.3%)检出SSLN。术中共检出SSLN148枚,其中有癌转移112枚。结论在实施AGC根治手术时,应用SSLN示踪技术能够准确预测区域淋巴结的转移状态,为个体化淋巴结清扫提供参考。 展开更多
关键词 胃肿瘤 进展期 淋巴结转移 二级前 哨淋巴结
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6头颈部黑色素瘤哨卫淋巴结对远期预后的预测及其意义
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《中国口腔颌面外科杂志》 CAS 2012年第3期235-235,共1页
Long-term prognosis and significance of the sentinel lymph node in head and neck melanoma. Parrett BM, Kashani-Sabet M, Singer MI, et al. Otolaryngol Head Neck Surg,2012 Apr 24. [Epub ahead of print]
关键词 头颈部 黑色素 淋巴结 临床分析
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护理干预在早期乳腺癌治疗中的应用
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作者 王锦晶 《中国卫生标准管理》 2019年第23期157-159,共3页
目的探讨护理干预在保乳综合治疗结合哨淋巴结活检治疗早期乳腺癌中的作用。方法回顾性分析本院2016年1月-2018年6月期间本院肿瘤外科收治的65例乳腺癌患者临床资料,所有患者均接受保乳综合治疗结合哨淋巴结活检治疗,围手术期接受本院... 目的探讨护理干预在保乳综合治疗结合哨淋巴结活检治疗早期乳腺癌中的作用。方法回顾性分析本院2016年1月-2018年6月期间本院肿瘤外科收治的65例乳腺癌患者临床资料,所有患者均接受保乳综合治疗结合哨淋巴结活检治疗,围手术期接受本院针对早期乳腺癌的护理干预措施。之后记录患者并发症发生情况、护理前后SAS、SDS评分。结果实施护理干预后患者SAS、SDS评分优于护理干预前,差异有统计学意义(P<0.05)。出院当天评价结果显示,患者满意度评分平均(92.45±4.12)分;随访半年,65例患者并发症总发生率为6.15%。结论针对行保乳综合治疗结合哨淋巴结活检治疗的早期乳腺癌患者,通过实施有针对性、合理的护理干预措施,可帮助改善患者心理状态,保证治疗效果。 展开更多
关键词 早期乳腺癌 保乳综合治疗 哨淋巴结活检 护理干预 心理情绪 护理满意度
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Application of sentinel lymph node (SLN) biopsy in breast cancer patients 被引量:1
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作者 Tao Zhang Baoning Zhang +6 位作者 Hong Wang Baoping Chen Xiliang Wei Ying Fu Lin Liu HongyingYang Shengzu Ghen 《The Chinese-German Journal of Clinical Oncology》 CAS 2007年第1期52-54,共3页
Objective: To discuss if the sentinel lymph node (SLN) biopsy is able to reflect the status of the axillary lymph node and the application of this technic in clinic. Methods: Using^ 99mTc-signed dextran, SLN-biop... Objective: To discuss if the sentinel lymph node (SLN) biopsy is able to reflect the status of the axillary lymph node and the application of this technic in clinic. Methods: Using^ 99mTc-signed dextran, SLN-biopsy (SLNB) was carried out in 182 cases with breast cancer during May 1999 to September 2006. During the operation, y-detector was used for orientation. After the SLNB, a modified radical mastectomy or breast conserving surgery were carried out to the patients, then a particular separate pathological examination of the SLN was made. Results: 178 cases of SLNB were carried out successfully, and the success rate was 97.8%, the out-checked SLN of each case ranged from 1 to 4, with an average of 2.5. All SLN was located at the first level of axilla, sensitivity of the SLN B was 93.4%, specificity was 100%, false negative rate was 6.6%, false positive rate was 0, accuracy was 97.8%, positive predictive value was 100.0%, negative predictive value was 96.7%, and Youden's index was 0.934. Immunohistochemical examination was carried out in 59 cases of SLN, and 14 cases showed the existences of micro-metastasis, however, metastasis had not been found in non-SLN of these cases. Conclusion: SLN is able to reflect the metastasis of the axillary lymph node, and this can suggest the necessity of the axillary dissection in clinic. The SLNB using the isotope-tracer technic is simple and accurate. 展开更多
关键词 breast neoplasms / surgery radionuclide imaging sentinel lymph node
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Distribution pattern of solitary lymph node in middle third gastric cancer
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作者 Caigang Liu Jian Wang +5 位作者 Ping Lu (Co-First Author) Yang Lu Jixian Shan Huimian Xu Shubao Wang Junqing Chen 《The Chinese-German Journal of Clinical Oncology》 CAS 2007年第5期444-446,共3页
Objective: To investigate the distribution pathway of sentinel lymph nodes (SLN) in middle third gastric carci-noma, as the foundation for rational lymphadenectomy. Methods: 52 cases of middle third tumors with solita... Objective: To investigate the distribution pathway of sentinel lymph nodes (SLN) in middle third gastric carci-noma, as the foundation for rational lymphadenectomy. Methods: 52 cases of middle third tumors with solitary lymph nodes from 1852 gastric carcinomas were selected. The locations and histological types of metastatic lymph nodes were analyzed retrospectively. Results: Of 52 solitary node metastases cases, 37 were limited to perigastric nodes (N1), while 15 with skipping metastasis. In the 35 cases with tumor of lesser curvature, there were 17 cases found lymph nodes of the lesser curvature side (No. 3), 5 cases involved lymph nodes of the greater curvature (No. 4), and 8 cases with lymph nodes of the left gastric artery (No. 7). In the 17 cases with tumor of greater curvature, 7 cases spread to No. 4, while 3 metastasized to lymph nodes of the spleen hilum (No. 10). The difference of the histological types in groups N1 and over N1, were not statistically significant (P > 0.05). Conclusion: Adjacent metastasis formed the primary distribution pattern of SLN in middle third gastric carcinoma, transversal and skipping metastases being also notable. 展开更多
关键词 gastric cancer lymph node metastasis sentinel lymph node
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Sentinel lymph node biopsy in renal malignancy: The past, present and future
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作者 Tharani Mahesan Alberto Coscione +1 位作者 Ben Ayres Nick Watkin 《World Journal of Nephrology》 2016年第2期182-188,共7页
Sentinel lymph node biopsy (SLNB) is now an establishedtechnique in penile and pelvic cancers, resulting in alower mortality and morbidity when compared withthe traditional lymph node dissection. In renal cancer how... Sentinel lymph node biopsy (SLNB) is now an establishedtechnique in penile and pelvic cancers, resulting in alower mortality and morbidity when compared withthe traditional lymph node dissection. In renal cancer however, despite some early successes for the SLNB technique, paucity of data remains a problem, thus lymph node dissection and extended lymph node dissection remain the management of choice in clinically node positive patients, with surveillance of lymph nodes in those who are clinically node negative. SLNB is a rapidly evolving technique and the introduction of new techniques such as near infra-red fuorescence optical imaging agents and positron emission tomography/computed tomography scans, may improve sensitivity. Evidence in support of this has already been recorded in bladder and prostate cancer.Although the lack of large multi-centre studies and issues around false negativity currently prevent its widespread use, with evolving techniques improving accuracy and the support of large-scale studies, SLNB does have the potential to become an integral part of staging in renal malignancy. 展开更多
关键词 Sentinel lymph node biopsy Dynamic sentinel node Renal malignancy LYMPHOSCINTIGRAPHY Near infra-red fuorescence Penile cancer Lymphatic drainage
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Signif icance of Sentinel Lymph Node Biopsy and Immunohistochemistry in Diagnosis and Staging of Stage-cN0 Oral Squamous Cell Carcinoma
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作者 Yong Ding Jingqiu Bu Jiahe Tian Rongfa Bu Baixuan Xu Mingzhe Shao 《Chinese Journal of Clinical Oncology》 CSCD 2007年第1期56-60,共5页
OBJECTIVE To assess the significance of sentinel lymph node biopsy (SLNB), serial section and cytokeratin immunohistochemical staining in the diagnosis and staging of Stage-cNO oral squamous cell carcinoma (OSCC),... OBJECTIVE To assess the significance of sentinel lymph node biopsy (SLNB), serial section and cytokeratin immunohistochemical staining in the diagnosis and staging of Stage-cNO oral squamous cell carcinoma (OSCC), METHODS A blue stain, 99mTc-dextran SPECT lymphoscintigrapgy and intraoperative y-ray probes were used to examine the sentinel nodes in 31 cases with Stage-oNO oral cancer, The H&E staining and a cytokeratin AE1/ AE3 immunohistochemistry (IHC) assessment, with serial sections, were conducted to provide results obtained from a routine pathological examination of lymph nodes, The value of the routine pathological examination of the sentinel lymph node (SLN), serial sections and IHC determination for cervical lymph node metastasis of Stage-cN0 OSCC was appraised, RESULTS A total of 45, 55 and 51 SLNs were examined in 25 (80%), 31 (100%) and 30 (96,5%) of the cases, by using the blue stain, y-ray probes, and SPECT lymphoscintigraphy, respectively, The average SLNs found in each case of the groups was 1,4 (1 to 3) and there were 1,302 non-NSLNs, Six positive SLN metastases were detected by routine pathological examination, among which 1 case was found to be an accompanied positive metastasis of non-SLN, One positive SLN metastasis was found after examination of serial sections plus routine H&E staining and 2 were detected using serial sections plus AE3 immunohistochemical staining methods, No positive NSLNs were found in the study, CONCLUSION In order to make more progress in accurate SLNB diagnosis, serial sections and IHC (AE1/AE3) methods can be used for examination of the micrometastases which are difficult to identify by routine pathological sections and H&E staining. 展开更多
关键词 oral squamous cell carcinoma sentinel lymph node MICROMETASTASIS serial sections immunohistochemistry.
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Evaluation of sentinel lymph nodes in vulvar, endometrial and cervical cancers
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作者 Jenna Emerson Katina Robison 《World Journal of Obstetrics and Gynecology》 2016年第1期78-86,共9页
Sentinel lymph node (SLN) biopsies are a sensitive tool in evaluating lymph nodes for multiple cancers, and in some diseases they decrease morbidity in both the short- and long-term. SLN detection in gynecologic mal... Sentinel lymph node (SLN) biopsies are a sensitive tool in evaluating lymph nodes for multiple cancers, and in some diseases they decrease morbidity in both the short- and long-term. SLN detection in gynecologic malignancies has been studied extensively over the past decade. We review the current literature on SLN dissection in vulvar, endometrial and cervical cancers. Large, well-designed trials in each of the three types of cancer have demonstrated high sensitivity and low false-negative rates when SLN biopsy is performed in the correct patients and with an appropriate technical approach. In all of these cases the addition of ultra-staging to conventional pathology yields increased detection of micrometastatic disease. Biopsy of the sentinel nodes is feasible and safe in early vulvar malignancies, with multiple studies describing low recurrence rates in those women who have with negative SLNs. There does not appear to be a survival benefit to lymphadenectomy over SLN biopsy and quality of life is improved in women undergoing SLN biopsy. Optimal treatment strategies for women with positive nodal biopsies, particularly in cases with micrometastatic disease, remain unclear. Multiple large studies investigating the utility of SLN biopsy in endometrial malignancy have found that sentinel nodal status is a reliable predictor of metastases in women with low-risk disease. Prospective studies are ongoing and suggest sentinel nodal detection may soon become widely accepted as an alternative standard of care for select cases of endometrial cancer. In cervical cancer, SLN biopsy is accurate for diagnosing metastatic disease in early stage tumors (≤ 2 cm diameter or stage ≤ IB2) where the risk of metastasis is low. It is unknown if women who undergo SLN biopsy alone will have different survival outcomes than women who undergo complete lymphadenectomy in these cases. In a specific population of women with vulvar cancer, SLN dissection is an effective and safe alternative to complete dissection. It can be offered as an alternative management strategy in these women. In women who do undergo SLN biopsy, it is associated with improved quality of life. Promising evidence supporting the utility of SLN dissection in endometrial and cervical cancer continues to emerge, and it may soon become a reasonable option for select patients. However, continued research and refnement of appropriate patient selection and long-term follow-up are necessary. 展开更多
关键词 Gynecologic malignancies Sentinel lymph node Endometrial cancer Cervical cancer Vulvar cancer
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Sentinel Lymph Node Identification in Endometrial Cancer
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作者 Bin Li Lingying Wu +5 位作者 Xiaoguang Li wHaizhen Lu Ping Bai Shumin Li Wenhua Zhang Jǖzhen Gao 《Chinese Journal of Clinical Oncology》 CSCD 2009年第2期124-128,共5页
OBJECTIVE To evaluate the feasibility of intra-operativedetection of sentinel lymph nodes (SLN) in the patient withendometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrialcancer, who underw... OBJECTIVE To evaluate the feasibility of intra-operativedetection of sentinel lymph nodes (SLN) in the patient withendometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrialcancer, who underwent a hysterectomy and a lymphadenectomy,were enrolled in the study. At laparotomy, methylene blue dyetracer was injected into the subserosal myometrium of corpusuteri at multiple sites, and dye uptake into the lymphatic channelswas observed. The blue nodes which were identified as SLNs weretraced and excised. The other nodes were then removed. All of theexcised nodes were submitted for pathological hematoxylin andeosin (H&E) staining examination.RESULTS Failure of dye uptake occurred in 4 of the 31 cases(12.9%) because of spillage, and no lymphatic coloration wasobserved there. Lymphatic staining was clearly observable as bluedye diffused to the lymphatic channels of the uterine surface andthe infundibulopelvic ligaments in 27 (87.1%) cases. Concurrentcoloration in the pelvic lymphatic vessels was also observed in 22of the 27 patients. The SLNs were identified in 23 of the 27 (85.2%)cases with a lymphatic staining, with a total number of 90 SLNs,and a mean of 3.9 in each case (range, 1-10). Besides one SLN (1.1%)in the para-aortic area, the other 89 (98.9%) were in the nodes ofthe pelvis. The most dense locations of SLNs included obturator in38 (42.2%) and interiliac in 19 (21.1%) cases. In our group, pelviclymphadenectomy was conducted in 27 (87.1%) patients andpelvic nodal sampling in 4 (12.9%). Of the 31 cases, a concurrentabdominal para-aortic lymph node sampling was conducted in7. A total of 926 nodes were harvested, with an average of 39.8 ineach case (range, 14-55). Nodal metastases occurred in 3 patients(9.7%), 2 of them with SLN involvement and the other withoutSLN involvement. Adverse reactions or injury related to the studywas not found.CONCLUSION Application of methylene blue dye is feasible inan intra-operative SLN identification of endometrial cancer. Thetechnology is convenient, safe, and worth further investigation. 展开更多
关键词 endometrial tumor lymphatic metastasis sentinel lymph node biopsy lymphadenectomy.
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《中国临床肿瘤学会乳腺癌诊疗指南2018.V1》外科问题解读 被引量:24
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作者 姚凡 金锋 《中国实用外科杂志》 CSCD 北大核心 2018年第11期1281-1284,共4页
新辅助化疗是局部晚期乳腺癌或炎性乳腺癌的规范疗法,可以使肿瘤降期以利于手术或将不可能手术转变为可以手术,一般应按照既定化疗方案周期数(6~8个周期)内最大疗效的原则进行。新辅助化疗后的保乳与常规保乳术后局部复发率间差异无统... 新辅助化疗是局部晚期乳腺癌或炎性乳腺癌的规范疗法,可以使肿瘤降期以利于手术或将不可能手术转变为可以手术,一般应按照既定化疗方案周期数(6~8个周期)内最大疗效的原则进行。新辅助化疗后的保乳与常规保乳术后局部复发率间差异无统计学意义,新辅助化疗后保乳切除范围应根据肿瘤初始状况、分子亚型、肿瘤化疗后退缩模式等综合考虑,切缘阴性是基本原则。新辅助化疗后的前哨淋巴结活检(SLNB)争议较多,对cN0病人新辅助化疗前后均可行SLNB,对于c N1-cN0病人可以考虑在双示踪剂、增加淋巴结检出数目、免疫组化病理学检查、应用标记夹等方法有效降低假阴性率(FNR)后行SLNB。Ⅳ期乳腺癌原发灶切除是否改善生存尚存争议,手术应在全身治疗有效的基础上进行,现阶段转移灶手术的主要目的是改善病人生存质量。 展开更多
关键词 中国临床肿瘤学会 新辅助化疗 保乳手术前 哨淋巴结活检 Ⅳ期乳腺癌
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浸润性乳腺癌(T_(1-2)N_(0)M_(0)期)SLNB阴性患者保腋窝术后预后的相关因素分析 被引量:3
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作者 游紫萱 陈红 +3 位作者 肖丽 马璐 但凤英 郑晓筱 《中华普外科手术学杂志(电子版)》 2021年第6期617-620,共4页
目的探究影响T_(1-2)N_(0)M_(0)期浸润性乳腺癌前哨淋巴结活检(SLNB)阴性行保腋窝术(APS)患者预后的相关因素。方法回顾性分析2014年1月至2016年8月行APS术的115例T_(1-2)N_(0)M_(0)期浸润性乳腺癌SLNB阴性患者资料。采用统计学软件SPSS... 目的探究影响T_(1-2)N_(0)M_(0)期浸润性乳腺癌前哨淋巴结活检(SLNB)阴性行保腋窝术(APS)患者预后的相关因素。方法回顾性分析2014年1月至2016年8月行APS术的115例T_(1-2)N_(0)M_(0)期浸润性乳腺癌SLNB阴性患者资料。采用统计学软件SPSS 22.0进行数据处理,复发、转移例数等计数资料使用[例(%)]表示,单因素生存分析采用K-M法,行Log-rankχ^(2)检验;Cox回归模型进行预后多因素分析,P<0.05为差异有统计学意义。结果115例患者均获得随访,时间27~49个月,中位随访时间为37个月,术后3例出现局部复发,2例出现区域复发,3例出现骨、胸膜转移,总复发转移率为7.0%(8/115),术后无病生存率为93.0%(107/115)。单因素分析显示,SLN检出数、肿瘤最大径、病理类型、组织学分级、脉管浸润及术后辅助治疗是影响患者预后无病生存率的危险因素(P<0.05)。Cox回归多因素分析显示,脉管浸润是影响患者预后无病生存的独立危险因素[HR(95%CI):2.213(1.567~4.201),P=0.005],术后辅助治疗是预后无病生存的保护因素[HR(95%CI):0.759(0.473~0.914),P=0.042]。结论伴随有脉管浸润会增加T_(1-2)N_(0)M_(0)期浸润性乳腺癌前哨淋巴结阴性患者术后复发的风险,是影响患者预后无病生存的独立危险因素。 展开更多
关键词 乳腺肿瘤 哨淋巴结活组织检查 保腋窝术 预后
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Sentinel lymph nodes lymphoscintigraphy and biopsy in breast cancer
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作者 徐敏 刘琳 +1 位作者 孙耘田 陈盛祖 《Chinese Medical Journal》 SCIE CAS CSCD 2002年第8期1137-1140,145-146,共4页
OBJECTIVES: To determine the clinical value of sentinel lymph node (SLN) detection by lympho- scintigraphy and gamma ray detecting probe (GDP) and to assess the value of hematoxylin and eosin (H&E) staining combin... OBJECTIVES: To determine the clinical value of sentinel lymph node (SLN) detection by lympho- scintigraphy and gamma ray detecting probe (GDP) and to assess the value of hematoxylin and eosin (H&E) staining combined with immunohistochemistry (IHC) analys is for detecting micrometastasis in lymph nodes (LNs).  METHODS: Forty-two patients with breast cancer were included in this study. (99)Tc(m)-dextran was injected peritumourally. Lymphoscintigraphy images were obtained in anterior and lateral views. SLNs were removed with the aid of GDP during surgery. A standard axillary lymph nodes (ALNs) dissection was performed. All lymph nodes were first analyzed by HE staining. When all of the SLNs in a patient were negative, the ALNs were subjected to additional HE staining combined with IHC analysis. RESULTS: SLNs were successfully detected and removed in 39 (92.9%) of the 42 patients. The sensitivity, specificity and accuracy of SLN biopsy were 92.9% (13 in 14), 100% (25 in 25) and 97.4% (38 in 39) respectively.  Additional HE staining combined with IHC analysis of the ALNs detected micrometastasis in 3 SLNs (2 cases), but there were no positives in the non-sentinal lymph nodes (NSLNs). CONCLUSIONS: This study suggests that lymphoscintigraphy and GDP may be used to detect SLN. Additional HE staining combined with IHC analysis of the ALNs may help predict micrometastasis. Biopsy of SLN may be an accurate method for staging breast cancer. 展开更多
关键词 Sentinel Lymph Node Biopsy ADULT Aged Breast Neoplasms DEXTRANS FEMALE Humans IMMUNOHISTOCHEMISTRY Lymph Nodes Middle Aged Organotechnetium Compounds
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Secondary sentinel lymph node tracing technique: a new method for tracing lymph nodes in radical gastrectomy for advanced gastric cancer 被引量:2
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作者 Zong-lin LI Huai-wu JIANG +3 位作者 Min SONG Liang XU Dong XIA Qing LIU 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2015年第11期897-903,共7页
Objective: To explore the feasibility and clinical value of secondary sentinel lymph node (SSLN) tracing technique in radical gastrectomy for advanced gastric cancer (AGC). Methods: From January 2009 to June 201... Objective: To explore the feasibility and clinical value of secondary sentinel lymph node (SSLN) tracing technique in radical gastrectomy for advanced gastric cancer (AGC). Methods: From January 2009 to June 2011,247 patients who suffered from gastric angle cancer with metastasis in No. 3 group lymph nodes were divided randomly into groups A and B. Methylthioninium chloride was injected into the peripheral tissue of the metastatic No. 3 group lymph nodes of 138 patients in group A before tumor resections. SSLNs were traced and individual lymphadenectomies were carried out based on the biopsy results of the SSLNs. Standard D2 radical gastrectomies were carried out directly on 109 patients in group B. Postoperative follow-up and survival analysis were carried out for patients in both groups. Results: SSLNs were found in 114 (82.6%) patients in group A. Ninety of those patients (78.9%) demonstrated existing metastasis in SSLNs. According to Kaplan-Meier's method, the postoperative 3-year cumulative survival rates were 63.5% and 47.5%, and the median survival time were 40 and 36 months for the patients of groups A and B, respectively (P〈0.05). Conclusions: The SSLN tracing technique is feasible in radical gastrectomy for AGC. It gives surgeons important information about the terminal status of lymph node metastasis and provides some scientific basis for individual lymphadenectomy. 展开更多
关键词 Secondary sentinel lymph node (SSLN) Advanced gastric cancer (AGC) Individual lymphadenectomy Survival analysis
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