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目的 寻找术中注射生物染料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 71例乳腺癌患者进行了术中注射亚甲蓝染色法检测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 71例患者中成功检测出SLN 70例 ,成功率为 97%。共检出SLN 188个 ,每例SLN 1～ 4个 ,平均每例检出SLN 2 7个。本研究分别出现 1例假阴性结果 ,假阴性率为 2 %( 1/ 42 )。 70例患者中有 2 8例SLN阳性 ,阳性率为 40 %;共检测出SLN76个 ,其中 5 7个为转移癌 ,转移率为 75 %( 5 7/ 76)。SLNB预测ALN的灵敏度为 96%,特异性为 10 0 %,准确性为 97%。结论 术中注射亚甲蓝染色检测乳腺癌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 intraoperative biochemical detection of sentinellymphnode (SLN) in breast cancer and to study the accuracy of sentinellymphnodebiopsy (SLNB) in predicting axillary lymph node status. Methods 71 cases of breast cancer patients underwent intraoperative injection of methylene blue staining SLN, axillary lymph node dissection (axilarylymphnodedissection ALND) lymph node metastasis were analyzed. All cases confirmed by pathology. Results Seventy patients were successfully detected in 70 SLN cases, the success rate was 97%. A total of 188 SLNs were detected, 1 to 4 SLNs in each case, and an average of 2 7 SLNs were detected in each case. One case of false negative results was found in this study, with a false negative rate of 2% (1/42). Among the 70 patients, 28 were positive for SLN, with a positive rate of 40%. A total of 76 SLNs were detected, of which 57 were metastatic carcinomas with a metastasis rate of 75% (57/76). The sensitivity of SLNB to predict ALN was 96%, specificity was 100% and accuracy was 97%. Conclusions Intraoperative injection of methylene blue staining for the detection of breast cancer SLN is economical and practical, which can accurately predict the metastasis of axillary lymph nodes