摘要
目的:研究不同临床分期乳腺癌新辅助化疗后前哨淋巴结活检(SLNB)的成功率和假阴性率,探讨SL-NB在不同临床分期乳腺癌患者中新辅助化疗后的临床价值。方法:以137例乳腺癌病人为研究对象,采用99mTc标记的大分子右旋糖苷(99mTc-Dx)联合亚甲蓝示踪前哨淋巴结(SLN)。临床分期为T1-2N0M0乳腺癌61例(A组),未行新辅助化疗,直接行SLNB。行新辅助化疗组76例(分B、C两组,其中B组T2-4N0-1M0病例39例,C组T2-4N2-3M0病例27例),术前先给予3-4个疗程的新辅助化疗,降期为T1-2N0-1M0后行SLNB。术后SLNB成功率及假阴性率进行统计学分析(卡方检验)。结果:A组成功率、假阴性率分别为93.44%(57/61)、7.41%(2/27)、B组分别为92.31%(36/39)、8.57%(3/35),C组分别为74.07%(20/27),18.52%(5/27)。A、B两组比较成功率、假阴性率均无统计学差异(P>0.05)。A、C两组相比,B、C两组相比有显著差异(P<0.05)。结论:不同临床分期乳腺癌患者新辅助化疗后SLNB的成功率和假阴性率有显著差异,腋窝淋巴结状况是淋巴结活检成功的影响因素,N0-1患者新辅助化疗后SLNB仍能准确预测腋窝淋巴结的状况。N2期以上患者成功率降低,假阴性率升高。
Objective：To study the successful rate and false negative rate of sentinel lymph node biopsy（SLNB） in the diagnosis of breast cancer at different clinical stages after neoadjuvant chemotherapy,and to research the clinical value of axillary lymph node biopsy.Methods：A total of 137 cases of breast cancer were enrolled in this clinical research from March 2003 to March 2007.All of the patients＇ sentinel lymph nodes（SLNs） were detected and labeled with 99mTc-Dx and methylene blue.Of the 137 cases,61 T1-2N0M0 cases carried SLNB without neoadjuvant chemotherapy（group A）,and 76 cases were carried out neoadjuvant chemotherapy 3-4 cycles before SLNB,including 39 T2-4N0-1M0 cases（group B） and 27 T2-4N2-3M0 cases（group C）.The successful and false negative rates of SLNB were compared with chi-square test.Results：The successful and false negative rates of SLNB were 92.31%（36/39） and 8.57%（3/35） in group A,92.31%（36/39） and 8.57%（3/35） in group B,and 74.07%（20/27） and 18.52%（5/27） in group C,respectively.The successful rate and false negative rate were significant different in group C from those in groups A and B respectively（P0.05）.Conclusion：The SLNB can accurately predict lymph node status of axillary lymph node in N0-1 stage patients after neoadjuvant chemotherapy,but in N2-3 stage patients the successful rate decreased and false negative rate increased significantly.
出处
《武汉大学学报（医学版）》
CAS
北大核心
2011年第5期627-629,633,共4页
Medical Journal of Wuhan University
基金
湖北省卫生厅资助项目(编号:NX200615)
关键词
乳腺癌
前哨淋巴结
新辅助化疗
Breast Cancer
Sentinel Lymph Node
Neoadjuvant Chemotherapy
