摘要
目的:探讨乳腺癌前哨淋巴结（sentinel lymph node,SLN）示踪技术的可行性及其临床意义。方法:将47例病理证实为乳腺癌而临床无腋淋巴结肿大的女性病人随机分为3组,其中活性染料isosulfan blue示踪29例、核素99m锝-硫胶体示踪8例、染料与核素联合示踪10例。确认并切除SLN,单独送病理,随后行乳腺癌手术,包括传统的腋淋巴结清扫术。结果:47例中有42例成功定位SLN,检出率90.1％,其中染料组86.2％（25/29）、核素组87.5％（7/8）、联合组100％（10/10）;全组总敏感性为92.8％,各组分别为90.0％、100％、100％;假阴性率7.1％,各组分别为10.0％、0％、0％;准确率98.6％,各组分别为96.0％、100％、100％。各组寻找SLN平均花费时间分别为22min、7min及6min。结论:三种轧腺癌SLN示踪检测技术在临床均可行,绝大多数SLN可较准确地反映其余腋淋巴结的组织学特点。活性染料与核素联合示踪既直观又准确,是3者中的最佳方法。
Objective: To evaluate the technic and clinical significance of the sentinel lymph node(SLN) biopsy in patients with breast cancer. Methods: From December 1999 through March 2001,47 female patients with clinical node-negative breast cancer underwent lymthatic mapping. They were divided into three groups such as blue dye (isosulfan blue), 99mtechnetium-labelled sulfurcolloid and combination of vital blue dye and radiocolloid. The cases in each group were 29, 8 and 10 respectively. The SLN was identified and removed,followed by a definitive cancer operation, including a complete axillary node dissection. Pathological examination of SLN was made with H&E and im-munohistochemical(IHC) staining. The results were analysed by combination of the pathological characteristics of other axillary nodes. Results: Among the 47 patients , there were 42 cases(90%) of successful SLN localization. The postive rate was 86. 2%(25/29), 87.5%(7/8) and 100% (10/10) respectively in three groups. The total sensitivity was 92. 8% and each group was 90. 0% , 100% and 100% respectively. The total false negative rate was 7. 1% and in each group was 10. 0% , 0% and 0% respectively. The total accuracy rate was 98. 6% and in each group was 96. 0%, 100% and 100% respectively and the time needed in finding the SLN was 22, 7 and 6 minites. Conclusions: The SLN localization and biopsy are technically feasible in patients with breast cancer. Most of the SLN might represent the histological characteristics of the axillary lymph nodes. Combination of using blue dye and isotope makes exact and satisfactory mapping, which may be the best choice among the three methods.
出处
《诊断学理论与实践》
2002年第1期15-18,共4页
Journal of Diagnostics Concepts & Practice
