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目的 寻找检测乳腺癌哨兵淋巴结 (sentinellymphnode ,SLN)方法 ,并研究哨兵淋巴结活检 (sentinellymphnodebiopsy ,SLNB)预测腋窝淋巴结状况的准确性。方法 对 2 7例乳腺癌患者进行了亚甲蓝染色法检测SLN ,与腋窝淋巴结切除术 (axilarylymphnodedissection ,ALND)后的淋巴结转移状况进行对比分析。全部病例经病理证实。结果 2 7例患者中成功检测出SLN 2 6例 ,成功率为 96%。共检出SLN 5 6个 ,每例SLN 1～ 4个 ,平均检出 2 2个。本研究共出现1例假阴性结果 ,未有假阳性 ,假阴性率为 12 % ,假阳性率为 0。 2 6例患者中有 10例SLN阳性 ,阳性率为 3 8% ;共检测出SLN 2 2个 ,其中 18个为转移癌 ,转移率为 82 % (18/ 2 2 )。SLNB预测ALN的灵敏度为 91% ,特异性为 10 0 % ,准确性为96%。结论 亚甲蓝染色法检测乳腺癌SLN经济实用 ,可以较准确地预测腋窝淋巴结的转移状况。
Objective To search for the method of detecting sentinellymphnode (SLN) in breast cancer and to study the accuracy of sentinellymphnodebiopsy (SLNB) in predicting axillary lymph node status. Methods Twenty-seven breast cancer patients were examined by methylene blue staining for lymph node metastasis after axillary lymph node dissection (ALND). All cases confirmed by pathology. Results Twenty-six SLNs were successfully detected in 27 patients with a success rate of 96%. A total of 65 SLNs were detected, with 1 ~ 4 SLNs per case and 2 2 SLNs detected on average. One case of false negative results was found in this study. There was no false positive, the false negative rate was 12% and the false positive rate was zero. 10 out of 26 patients were positive for SLN, with a positive rate of 38%. Two SLNs were detected, of which 18 were metastatic and the metastasis rate was 82% (18/2). SLNB predicts the sensitivity of ALN is 91%, the specificity is 100%, the accuracy is 96%. Conclusion methylene blue staining SLN breast cancer is economical and practical, can more accurately predict the metastasis of axillary lymph nodes.