【摘要】 目的　探讨蓝色染料和核素方法在乳腺癌前哨淋巴结定位活检中的可靠性、准确性和临床应用价值。方法　运用异硫蓝或99Tc硫胶体结合术中γ探头或联合两种方法对6 1例腋淋巴结阴性的乳腺癌病人进行前哨淋巴结定位活检。结果　前哨淋巴结定位活检总成功率为95 .1% (5 8/ 6 1) ,2例假阴性,假阴性率7.7% ,敏感性92 .3% ,前哨淋巴结预测区域转移准确率96 .6 % ,特异性10 0 .0 %。单用蓝色染料方法的成功率88.2 % ,假阴性率12 .5 % ,敏感性87.5 % ,准确率93.3% ;单用放射核素结合术中γ探头,成功率为95 .2 % ,假阴性率11.1% ,敏感性88.9% ,准确率95 .0 % ;两种方法联合,成功率10 0 .0 % ,无假阴性,敏感性10 0 .0 % ,准确率10 0 .0 %。结论　前哨淋巴结定位活检在乳腺癌中能很好反映腋淋巴结转移状况,对指导乳腺癌腋淋巴结清扫的必要性和合理性有极大的应用价值。蓝色染料和核素探测两者相互补充,可提高前哨淋巴结的成功率和准确率更多还原

【Abstract】 Objective To study the feasibility, acc ur acy and clinical significance of sentinel lymph node biopsy (SLNB) using blue dy e and isotope in patients breast cancer. Methods From March 199 9 to July 2003, 61 breast cancer patients with clinically-negative axillary lym ph nodes underwent sentinel lymph node biopsy. The results obtained with isosulf an blue dye or 99m-Technetium labeled sulfur colloid with intraoperative γ pro be,or combination of isosulfan blue and sulfur colloid were compared. R esults The overall success rate of SLNB was 95.1% (58/61), two false ne g ativities with a false negative rate of 7.7%, sensitivity of 92.3%, regional met astasis predicting accuracy of 96.6% and specificity of 100 0%. In cases with i sosulfan blue dye alone, the success rate was 88.2%, with a negative rate of 12. 5 %, sensitivity of 87.5%, accuracy of 93.3%. In cases with sulfur colloid alone, the success rate was 95.2%, with a negative rate of 11.1%, sensitivity of 88.9%, accuracy of 95.0%. In cases with combination of two methods, the success rate w as 100 0%, there was no false negativity: the sensitivity and accuracy rate wer e both 100.0%. Conclusion SLNB could accurately predict the sta tu s of axillary lymph node basin of breast cancer which would have great value in evaluation of necessity and rationality of lymphadenectomy. The combination of b lue dye and sulfur colloid could improve the success rate and accuracy of SLNB.更多还原