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目的探讨前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)在乳腺外科中的临床应用,摸索其可行性及准确性。方法对2004年以来收治的Ⅰ、Ⅱ期乳腺癌患者38例,术前于肿瘤表面皮内周围联合注射99mTc-DX及美蓝,术前、术中用γ-探测仪探测SLN的位置,并通过美蓝染色寻找SLN,行SLNB后,常规行乳腺癌手术,术后对SLNB和腋窝淋巴结清扫(axillary lymph node dissection,ALND)的病理结果进行比较分析。结果 38例中37例发现SLN,检出率为97.4%(37/38),共检出SLN73个,平均1.97个,本组SLNB的检出灵敏度为97.3%(36/37),准确性97.3%(36/37),假阴性率2.6%(1/38),假阳性率为0。结论乳腺癌SLNB是一种简便、安全的检测技术,可用于了解腋窝淋巴结的状况。乳腺癌治疗失败的主要原因并不在于局部复发而在于远处转移,SLNB是乳腺癌治疗中的实用技术。
Objective To investigate the clinical application of sentinel lymph node biopsy (SLNB) in breast surgery and explore its feasibility and accuracy. Methods Thirty-eight patients with stage Ⅰ and Ⅱ breast cancer admitted to our hospital from 2004 were enrolled. 99mTc-DX and methylene blue were injected intradermally around the tumor surface before surgery. The location of SLN was detected by γ-detector before and during operation. SLN was found by methylene blue staining, and breast cancer was performed routinely after SLNB. Pathological results of SLNB and axillary lymph node dissection (ALND) were compared and analyzed. Results Among the 38 cases, SLN was detected in 37 cases (97.4%, 37/38). A total of 73 SLNs were detected, with an average of 1.97. The detection sensitivity of SLNB in this group was 97.3% (36/37) and the accuracy was 97.3% % (36/37), false negative rate of 2.6% (1/38), false positive rate of 0. Conclusion Breast cancer SLNB is a simple and safe detection technique that can be used to understand the status of axillary lymph nodes. The main reason for the failure of breast cancer treatment is not local recurrence but distant metastasis. SLNB is a useful technique in the treatment of breast cancer.