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【目的】探讨美蓝法示踪和定位行乳腺癌前哨淋巴结活检(SLNB)的可行性及其临床意义,并探索常规病理检查(HE染色)、免疫组化染色(IHC染色)及逆转录聚合酶链反应(RT-PCR)技术对判断前哨淋巴结(SLN)微转移灶的价值。【方法】66例乳腺癌患者,用美蓝示踪行SLNB,对SLN及腋窝淋巴结(ALN)进行HE染色;随机选取40例SLN进一步行细胞角蛋白19(CK19)的IHC染色及RT-PCR检测;比较3种方法对SLN微转移灶检出的敏感性、准确率及假阴性率的差异。【结果】66例中,美蓝示踪成功检出63例,检出率达95.5%。IHC与RT-PCR比较无差异,而与HE比较差异有显著性。【结论】美蓝法SLNB也有很高的检出率,由于常规病理检查对微转移的诊断率低,结合IHC及RT-PCR检测能则有效判断乳腺癌腋淋巴结转移状态,提高SLN中微转移的检出率,降低假阴性率。
【Objective】 To investigate the feasibility and clinical significance of the methylene blue method for tracing and locating sentinel lymph node biopsy (SLNB) in breast cancer and to explore the correlation between routine pathological examination (HE staining), immunohistochemical staining (IHC) and reverse transcription polymerase chain reaction The value of enzyme-linked-chain reaction (RT-PCR) in judging micrometastasis of sentinel lymph node (SLN). 【Methods】 Sixty-six patients with breast cancer were stained with methylene blue followed by HE staining of SLNs and axillary lymph nodes (ALN). IHC staining and RT-PCR of cytokeratin 19 (CK19) The sensitivity, accuracy and false-negative rate of SLN micrometastases were compared between the three methods. 【Results】 Sixty-six cases were successfully detected by methylene blue tracer, the detection rate was 95.5%. There was no difference between IHC and RT-PCR, but significant difference with HE. 【Conclusion】 Methyl blue has a high detection rate of SLNB. Because of the low diagnostic rate of micrometastases by routine pathological examination, combined with IHC and RT-PCR, it can effectively determine the status of axillary lymph node metastasis and improve the micrometastasis in SLN The detection rate, reduce the false negative rate.