摘要
目的探讨逆向腋淋巴显影技术在乳腺癌患者腋窝淋巴结清扫中的应用价值。方法对拟行腋窝淋巴结清扫的70例乳腺癌患者采用亚甲蓝注射液行逆向腋淋巴显影技术检查,通过病理分析确诊有无淋巴结转移,并采用单因素分析及多元Logistics回归分析探讨逆向腋淋巴显影技术识别淋巴结或淋巴管的影响因素。结果本组70例乳腺癌患者检出淋巴结或淋巴管61例(87.14%),检出淋巴结38个,平均淋巴结数量为1.5个,且大多数位于A区。逆向腋淋巴显影技术淋巴结或淋巴管未识别患者接受新辅助化疗、放疗的比例显著高于淋巴结或淋巴管识别患者(P<0.05),T分期、N分期显著高于淋巴结或淋巴管识别患者(P<0.05),雌激素受体、孕激素受体和人表皮生长因子状态与淋巴结或淋巴管识别情况无明显相关性(P>0.05)。多元Logistics回归分析显示,新辅助化疗和N分期是引起逆向腋淋巴显影技术未识别淋巴结或淋巴管的危险因素(P<0.05或0.01),新辅助化疗和N分期是引起未识别的重要危险因素(P<0.05)。结论逆向腋淋巴显影技术可为乳腺癌患者腋窝淋巴结清扫提供参考,但对接受新辅助化疗、放疗及临床T分期、N分期较高患者淋巴结或淋巴管识别率较低,新辅助化疗和N分期高是影响其识别率的重要危险因素。
Objective To explore the application value of axillary reverse mapping(ARM)on axillary lymph node dissection in patients with breast cancer.Methods A total of 70 patients with breast cancer who were scheduled to undergo axillary lymph node dissection were examined by methylene blue injection for ARM.Pathological analysis was conducted for presence or absence of lymph node metastasis.Univariate analysis and multivariate logistics regression analysis were used to explore the influencing factors of ARM in identifying lymph node or lymphatic vessel.Results Among the 70 patients with breast cancer,61 cases(87.14%)were detected with lymph nodes or lymphatic vessels,and 38 lymph nodes were detected and the average number of lymph nodes was 1.5,and most of them were located in A area.The proportions of patients receiving neoadjuvant chemotherapy and radiotherapy in patients with ARM lymph node or lymphatic vessel non-identification were significantly higher than those in patients with lymph node or lymphatic vessel identification(P<0.05),and the T staging and N staging were significantly higher than those in patients with lymph node or lymphatic vessel identification(P<0.05).Estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factoR2(HER-2)had no significant correlation with lymph node or lymphatic vessel identification(P>0.05).Multivariate logistics regression analysis showed that neoadjuvant chemotherapy and N staging were risk factors for ARM lymph node or lymphatic vessel non-identification(P<0.05 or 0.01).Neoadjuvant chemotherapy and N staging were important risk factors for non-identification(P<0.05).Conclusions ARM can provide the reference for axillary lymph node dissection in patients with breast cancer,but has a lower identification rate of lymph nodes or lymphatic vessels among patients with neoadjuvant chemotherapy and radiotherapy and patients with higher clinical T staging and N staging,and neoadjuvant chemotherapy and high N staging are important risk factors affecting the identification rate.
作者
秦智军
孙萍
李龙飞
Qin Zhijun;Sun Ping;Li Longfei(Puyang Oilfield General Hospital,Puyang 457000,Henan,China)
出处
《临床心身疾病杂志》
CAS
2022年第6期42-47,共6页
Journal of Clinical Psychosomatic Diseases
基金
濮阳市科技攻关计划项目(编号2018225987)。
