【摘要】 目的　探讨美蓝染色法鉴别哨兵淋巴结 (SLN )的可行性及其活检的临床意义。方法　采用美蓝染色法 ,对 5 0例乳腺癌患者行腋窝淋巴作图 ,所得SLN和非哨兵淋巴结 (NSLN )均行常规HE染色。阴性SLN再行连续切片及免疫组化检查。结果　 5 0例患者中SLN阳性 45例 ,SLN鉴别成功率为 90 .0 %。 45例中常规病检 16例SLN阳性 ,对 2 9例SLN阴性者采用连续切片和免疫组化检查发现 7例 ( 2 4.1%)有微转移。哨兵淋巴结活检的准确率、灵敏度和假阴性率分别为 91.1%,85 .7%和 8.9%。结论　采用美蓝染色法能准确鉴别SLN ,反映乳腺癌患者腋窝淋巴结状况。采用连续切片和免疫组化检查可检测出NSLN中的微转移灶 ,降低假阴性率。更多还原

【Abstract】 Objective To study the possibility of identification of the sentinel lymph node(SLN) by methylene blue intraoperatively and the clinical significance of sentinel lymph node biopsy(SLNB) in patients with breast cancer.Methods Mapping lymphatic were performed by methylthionius stain in 50 patients with breast cancer.Both SLNs and nonsentinel lymph nodes(NSLN) were examined by routine HE staining.In addition all negative SLNs were examined by serial section(SS) and immunohistochemical(IHC) stain.Results SLN were successfully identified by methylthionius stain in 45 out of 50(90%) patients.16 SLNs were found positive also with routine histological exam,while 7 cases(24.13%) of micrometastasis were found by SS and IHC methods in other 29 negative SLNs.The accuracy rate,sensitivity and the false negative rate of the SLNB was 91.1%,85.7% and 8.9%,respectively.Conclusion By this technique SLN could accurately be identified,and the axillary node status could be predicted in patients with breast cancer.By SS and IHC methods the micrometastasis case of negetive SLN with routine histological exam coulded detected.更多还原