【摘要】 目的评价前哨淋巴结活检(SLNB)对预测乳腺癌腋窝淋巴结(ALN)肿瘤转移的临床价值;分析影响前哨淋巴结(SLN)检出率的因素。方法选择T1-2N0M0乳腺癌患者80例。取1%亚甲蓝3～5ml分四部位注射在乳腺肿瘤表面或取活检部位周围皮下组织内。此后,行不同方式的乳腺癌根治术,将所有SLN、非SLN送病理检查。将腋窝淋巴结转移情况与SLN进行对比;分析SLN检出率及影响检出率的因素。结果80例患者中76例检到SLN,检出成功率95%(76/80),敏感度86.21%(25/29),准确性94.74%(72/76),假阴性率13.79%(4/29),特异性100%(51/51),总阳性预测值为100%(25/25),总阴性预测值92.73%(51/55)。SLN检出率与术前化疗有关(P<0.05),与年龄、肿瘤位置、病理类型、雌激素受体(ER)无关(P>0.05)。结论SLNB敏感度较高,基本能准确地判断乳腺癌腋窝淋巴结转移情况。亚甲蓝染色法检测乳腺癌SLN经济实用。更多还原

【Abstract】 Objective To evaluate the value of sentinel lymph node biopsy(SLNB) in predicting axillary lymph node (ALN) metastasis status in breast cancer patients. To analyze the associated factors in identifiction of sentinel Lymph node (SLN). Methods 1% methylene blue 3 ～ 5ml was injected subcutaneously at 4 sites around the primary breast cancer mass. 80 cases were staged as T1-2 N0M0. Radical operation were performed in all patients. All the SLN and Non- SLN were assessed in pathohistological examination. The relation between status of anxillaries ALN and SLN were analyzed. The associated factors with identifiction of SLN were analyzed. Results SLN were identified in 76 of cases. The successful detetion rate was 95% and the sensitivity was 86.21 %(25/29). The accuracy of ALN metastasis predicting was 94.74% (72/76). The false negative rate was 13.79% (4/29) and the specificity was 100% (51/51). Age, location and size of tumor, histological type, ER status were not associated with intraoperative detection rate of SLN (P > 0.05). Chemotherapy before operation was related with the indentification of SLN at operation (P < 0.05 ). Conclusions SLNB generally can predict the ALN metastasis of primary breast cancer with high accuracy and sensitivity. Methylene blue injection is cheap and can be widely used to help in identifying SLN.更多还原