摘要
目的通过乳腺癌前哨淋巴结(sentinel lymph node,SLN)引流区域的临床研究验证乳腺癌SLN不仅仪足ljl流乳腺原发肿蝌区域的SI.N,而可能足引流整个乳腺器官的SLN。方法选取2004年4月至2008年12月收治的有前哨淋巴结活检(sentinel lymph node biopsy.SLNB)指征而不同意行SLNB替代腋清扫术的103例乳腺癌患者进入该研究。所有患卉均以"'rr(-.硫胶体("。n—sc)注射于乳腺肿瘤表l丽皮下,染料示踪剂分别注射于乳晕区皮下(73例)或肿瘤对角线部位皮下(30例)。SLNB后施行腋f肯扫术。结果核素染料联合法、核素法与染料法SLNB成功率分别为100%、97.1%和95.1%(P=0.286),SLNB的似阴性率分别为7.9%、8.1%和8.1%(P=0.999)。同时获得染料与核素法SLN定位的95例患者,至少有1个SLN被2种方法同时定佗,不同部位注射不同示踪剂SLN定位的符合率为100%,有显著相关性(spearman相关系数O.695,P<0.01)。结论肿瘤表面、乳晕区、对侧象限的不同部位皮下注射不同的示踪剂可以引流到同一SLN;支持乳腺癌SLN不仅是乳腺肿瘤的SLN,而且是整个乳腺器官的SLN;乳腺癌SLN的新理念有助于l临床实践中示踪剂注射部位的个体化和SLNB适应证的扩大。
Objective To validate the hypothesis that SLN （ Sentinel lymph nodes） is not only the lymphatic drainage of the entire breast, but also the tumor region. Methods From Apr. 2004 to Dec. 2008, 103 breast cancer patients were included in this study, who had the indications for sentinel lymph node biopsy （ SL- NB）, but refused to accept the SLNB in stead of axillary node dissection. ^99m Tc-labeled filtered sulfur colloid （^99m Tc-SC） was injected subdermally directly over the breast tumor in all cases, and dye tracer was injected subdermally into the subareolar location in 73 cases or the diagonal quadrant. All patients received axillary node dissection following SLNB. Results With the combination method, 99mTe-SC, and dye, the SLN identification rate was 100%, 97.1%, and 95.1%, respectively （P =0. 286）, and false negative rate was 7.9% , 8.1% , and 8.1% , respectively （P =0. 999）. In the 95 patients with SLN identified successfully with both 99mTc-SC and dye, there were at least one SLN that was beth blue and nuclide-labeled. The 99mTc-SC/dye concordance rate was 100% （ Spearman coefficient correlation 0. 695, P 〈 0.01 ）. Conclusions The results showed that the lymphatic drainage of the different location of the breast （the breast tumor site, the subareolar plexus, and the diagonal quadrant） can reach to the same SLNs, and validated the hypothesis that SLNB is not only the lym- phatic drainage of the entire breast, but also the tumor region. The new concept of SLN is helpful to the individualization of the tracer injection site and the enlargement of the SLNB indications.
出处
《中国肿瘤外科杂志》
CAS
2009年第3期137-140,共4页
Chinese Journal of Surgical Oncology
关键词
乳腺癌
前哨淋巴结
淋巴引流区域
breast cancer
sentinel lymph node
lymphatic drainage region
