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目的评价前哨淋巴结活检术(SLNB)预测腋窝淋巴结(ALN)转移状况的准确性及临床意义。方法2002年6月至2005年6月对120例女性乳腺癌病人联合使用美蓝溶液及99mTc-右旋糖酐(DX)示踪,γ记数探测仪定位,行SLNB。结果前哨淋巴结(SLN)检出率为98.3%,准确率为97.5%,假阴性率为6.5%,冰冻切片和连续石蜡切片加免疫组化检查的符合率为92.4%。结论SLNB可以准确预测ALN转移状况;联合法并术中使用γ记数探测仪是SLN定位的首选方法;多枚ALN转移可能使假阴性率升高。
Objective To evaluate the accuracy and clinical significance of SLNB in predicting axillary lymph node (ALN) metastasis. Methods From June 2002 to June 2005, 120 female patients with breast cancer were treated with methylene blue solution and 99mTc-dextran (DX) tracer. The γ-ray detector was used to locate SLNB. Results The detection rate of sentinel lymph node (SLN) was 98.3%, the accuracy rate was 97.5% and the false negative rate was 6.5%. The coincidence rate of frozen section and continuous paraffin section with immunohistochemistry was 92.4%. Conclusion SLNB can accurately predict the status of ALN metastasis; combined with intraoperative use of γ detector is the preferred method of SLN localization; multiple ALN metastases may increase false negative rate.