摘要
目的:分析乳腺癌前哨淋巴结的临床与病理,为前哨淋巴结转移寻找快速、准确的检测方法,为保腋窝手术(ALND术)提供理论依据;了解乳癌病理类型和ER、PR与SLN癌转移间的关系。方法:62例乳腺癌患者术前经空芯针穿刺石蜡切片确诊并确定其病理类型,用免疫组织化学方法检测雌、孕激素受体(ER、PR),术中采用亚甲蓝示踪剂定位法对前哨淋巴结活检(SLNB),采用印片法、冷冻切片常规HE染色及免疫荧光化学方法检测前哨淋巴结的转移情况,并与术后石蜡切片免疫组织化学方法比较,分析乳癌病理类型和ER、PR与SLN癌转移间的关系。结果:55例行SLNB,成功率为88.7%;SLN阳性印片法14例,灵敏性为66.67%(14/21),与石蜡切片免疫酶组织化学方法比较,χ2=6.17,P<0.05;冷冻切片常规HE染色SLN阳性15例,灵敏性为71.43%(15/21),与石蜡切片免疫酶组织化学方法比较,χ2=4.86,P<0.05;冷冻切片免疫荧光化学方法与石蜡切片免疫酶组织化学方法均为21例,灵敏性为100.00%(21/21);乳腺癌ER、PR表达与SLN癌转移无显著性差异;浸润性小叶癌15例,SLN阳性9例,浸润性导管癌40例,SLN阳性12例,两者比较,χ2=4.16,P<0.05;假阴性1例,假阴性率为2.94%(1/34)。结论:术中冷冻切片免疫荧光化学方法检测CK19对SLN癌转移的灵敏性高,可增加SLN转移的检出率,减少假阴性率;乳癌ER、PR表达与SLN癌转移无相关性;浸润性小叶癌SLN转移高于浸润性导管癌。
Objective：To analyze the clinical and pathological characteristics of sentinel lymph nodes（SLN） of breast cancer,seek a quick and accurate detection method for SLN metastasis,provide a theoretical basis for axilla conserving surgery;understand the relationship between pathological types of breast cancer and estrogen receptor（ER）,progestogen receptor（PR）,and SLN metastasis.Methods：Sixty-two patients were diagnosed as breast cancer by hollow needle biopsy and paraffin-embedded sections,then the pathological types were determined;immunohistochemical method was used to detect the levels of ER and PR;SLN biopsy was conducted by methylene blue localization method during operation.West blot,routine HE staining of frozen sections,and immunofluorescence were used to detect SLN metastasis,then the results were compared with those of immunohistochemical method of postoperative paraffin-embedded sections,the relationship between pathological types of breast cancer and ER,PR,and SLN metastasis was analyzed.Results：SLN biopsy was conducted in 55 cases,the successful rate was 88.7%.Fourteen cases with positive SLN were found by West blot,the sensitivity was 66.67%（14/21）,compared with immunohistochemical method,χ2=6.17,P〈0.05;15 cases with positive SLN were found by routine HE staining of frozen sections,the sensitivity was 71.43%（15/21）,compared with immunohistochemical method,χ2=4.86,P〈0.05;21 cases with positive SLN were found by immunofluorescence and immunohistochemical method,the sensitivity was 100.00%（21/21）;there was no significant correlation between ER expression and PR expression in breast cancer and SLN metastasis;among 15 cases with invasive lobular carcinoma,9 cases were found with positive SLN;among 40 cases with invasive ductal carcinoma,12 cases were found with positive SLN,χ2=4.16,P〈0.05;one case was found with false negative result,the false negative rate was 2.94%（1/34）.Conclusion：The sensitivity of immunofluorescence of intraoperative frozen sections is high for
出处
《中国妇幼保健》
CAS
北大核心
2012年第19期2923-2927,共5页
Maternal and Child Health Care of China
基金
贵州省遵义市科技基金资助〔遵市和社字(2007)04号〕
关键词
乳腺肿瘤
前哨淋巴结活检
免疫荧光组织化学
CK19
免疫组化学
ER、PR
Breast neoplasm
Sentinel lymph node biopsy
Immunofluorescence histochemistry
CK19
Immunohistochemistry
Estrogen receptor
Progestogen receptor
