摘要
目的探讨哨兵淋巴结活检 (SLND)在临床Ⅰ ,Ⅱ期乳腺癌中应用的可行性。方法使用亚甲蓝对 12 6例临床Ⅰ、Ⅱ期乳腺癌进行SLND ,随后行腋窝淋巴结清扫。腋窝阴性患者再行淋巴结的多水平切片和免疫组化 (IHC)检查。结果SLND成功率 75 4% ,灵敏度 91 7% ,特异度10 0 % ,阳性预测价值 10 0 % ,阴性预测价值 95 2 %。术中哨兵淋巴结 (SN)冰冻病理学检查的准确率93 4%。淋巴结多水平切片IHC发现 35例中 1例患者SN有微小转移 ( 2 9% )。结论SLND可以准确预测乳腺癌患者腋窝淋巴结状态 ,SN多水平切片IHC检测有助于提高SLND的敏感性。
Objective To study the significance of sentinel lymph node biopsy (SLND) in clinical stage Ⅰ,Ⅱ breast cancer patients. MethodsFrom January 1999 to January 2000, 126 patients with clinically stage Ⅰ,Ⅱ breast cancer received SLND guided by methylenc blue staining, and axillary lymph nodes clearance. Multilevel section and Immunohistochemistry (IHC) were performed in lymph nodes of patients with negative nodes. Results SN was identified in 95/126 cases(75.4%). The sensitivity of SLND was 91.7%, the specificity was 100%. It had 100% positive predictability and 92.5% negative predictability. The accuracy rate of intraoperative frozen-section examination of SN was 93.4%. One of 35 patients (2.9%) with H&E negative nodes had evidence of lymph node metastasis in the SN by multilevel sectioning and IHC.ConclusionSLND is extremely accurate in prediction of the lymph node status in patients with breast cancer. Multilevel sectioning and IHC analysis of SN improves the sensitivity of this staging technique.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第3期133-135,共3页
Chinese Journal of General Surgery
