摘要
目的 :研究乳腺癌前哨淋巴结的定位活检方法 ,探讨前哨淋巴结对腋窝淋巴结状态的预测价值及其临床意义。方法 :对4 8例乳腺癌病人 ,采用专利蓝和 99锝标记的大分子右旋糖苷 (99m Tc- DX)为示踪剂行前哨淋巴结显像 ,术中先进行前哨淋巴结定位活检 ,送快速冰冻病理检查 ,再作乳腺癌手术 ,全部病人均作腋窝淋巴结清扫。结果 :4 8例病人中有 4 4例找到前哨淋巴结 ,成功率 91.7%。其中 2 0例病人联合应用专利蓝和 99m Tc- DX两种方法定位前哨淋巴结 ,成功率 10 0 %。 4 4例病人共找到前哨淋巴结 (SL N) 95个 ,病理检查 36个有癌转移 ,非前哨淋巴结 (NSL N) 4 5 7个 ,病理检查 73个有癌转移。 4 4例病人中 ,SL N、NSL N均无转移 2 5例 ,SL N、NSL N均有转移 11例 ,SL N有转移但 NSL N无转移 7例 ,SL N未见转移但 NSL N检测到癌转移1例。结论 :SL N定位活检成功率高 ,联合应用专利蓝和 99m Tc- DX两种方法优于单用一种方法。SL N定位活检能较准确地预测腋窝淋巴结状态。 SL N假阴性 ,或淋巴结跳跃性转移 ,需要进一步研究。
Objective:To study the method of sentinel lymph nodes (SLN) biopsy in breast cancer, and to study the value of SLN in predicting the condition of axillary nodes and its clinical significance.Methods:Forty-eight patients with clinical node-negative breast cancers underwent intraoperative lymphatic mapping using patent blue dye alone (28 cases) and combination of patent blue dye and 99m Tc-DX (20 cases). The SLN was identified and removed, then radical mastectomy was performed, including a complete axillary node dissection.Result:SLN was successfully identified in 91.7% patients (44/48). When patent blue dye and 99m Tc-DX were used together, SLN was successfully identified in 100% patients(20/20). 95 SLN and 457 none sentinel lymph nodes (NSLN) were found in 44 patients with successful lymphtic mapping, 36 nodes were found to have metastases in 95 SLN, and 73 nodes were found to have metastases in 457 NSLN. Of 44 patients, neither SLN nor NSLN had metastases in 25 cases, both SLN and NSLN had metastases in 11 cases, SLN had metastases but NSLN did not have metastases in 7 cases; SLN did not have metastases but NSLN had metastases in 1 case.Conclusion:This study indicated that intraoperative lymphatic mapping could accurately identify sentinel lymph nodes,and the success rate achieved by combining the two mapping techniques (patent blue dye and 99m Tc-DX ) was higher than the rate of using patent blue dye alone. Generally, SLN biopsy can accurately predict the condition of axillary nodes. It is necessary to carry out further study that SLN was false positive or lymph nodes had jumping metastases.
出处
《广西医科大学学报》
CAS
2003年第5期633-635,共3页
Journal of Guangxi Medical University
基金
广西科技攻关项目资助 (桂科攻 0 0 15 0 3 2 )
