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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
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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
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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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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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《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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