缺乏核素示踪的早期乳腺癌前哨淋巴结活检方法临床研究

目的探讨应用亚甲蓝单示踪剂行缺乏核素示踪的早期乳腺癌前哨淋巴结活检(SLNB)的临床经验.方法收集行全乳切除手术或保乳手术的早期乳腺癌患者109例(0期12例,Ⅰ期27例,ⅡA期28例,ⅡB期10例)为研究对象,所有患者通过临床和影像学检查评估腋窝淋巴结阴性状态,对其行亚甲蓝示踪前哨淋巴结活检(SLNB)、非前哨淋巴结活检(Non-SLNB)和腋窝淋巴结清扫(ALND)的患者资料进行分析,所有前哨淋巴结(SLN)、非前哨淋巴结(Non-SLN)和腋窝淋巴结(ALN)均行病理学和免疫组化检查.结果 SLN检出率、假阴性率、准确性、阴性预测值分别为97.24%,6.9%,98.1%,97.5%.病理N分期的SLN检出率间比较差异具有统计学意义(P0.05).结论应用亚甲蓝单示踪法行SLNB能准确预测缺乏核素示踪的早期乳腺癌腋窝淋巴结状态,本研究入组的病例提示前哨淋巴结的检出率和准确率与乳腺癌的N分期相关.

Clinical Study on Sentinel Lymph Node Biopsy for Early Breast Cancer Patients without Radioactive Tracer

Objective To investigate the feasibility, accuracy and clinical experience of sentinel lymph node biopsy ( SLNB) for early breast cancer patients using methylene blue dye. Method 109 breast cancer cases (staging 0 of 12 cases,staging I of 27cases,staging ⅡA of 28 cases,staging ⅡB of 10 cases) were enrolled in this study. All the patients had no suspicious axillary lymph nodes by clinical examination and ultrasonography. The results of SLNB by using methylene blue dye as a single tracer,non-sentinal lymph node biopsy and axillary lymph node dissection ( ALND ) were retrospectively reviewed. All the SLN, non-SLN and ALN specimens underwent histopathological and immunohistochemestry examinations. Results The SLN successful identification rate,false negative rate, accuracy, and negative predictive value were 97. 24% , 6. 9% , 98. 1% , 97. 5% , respectively. The difference in SLN identification rate stage was significant (P<0. 05). Conclusion SLNB using methylene blue dye can accurately predict the lymph node status of axillary lymph node in early breast cancer patients. The detection rate and accuracy of SLNB is correlated with pathalogical N stage.