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目的探讨内乳前哨淋巴结的意义及其在临床上的应用价值。方法对我院29例符合内乳淋巴结转移高危因素的患者,经蓝染示踪后,行内乳淋巴结清除,在内乳区标本中确认蓝染的前哨淋巴结。结果 29例患者共检出内乳区蓝染前哨淋巴结22例。最终病理显示,内乳淋巴结有转移者12例,其中8例为蓝染的内乳区前哨淋巴结有转移且内乳淋巴结有转移;2例为仅蓝染的内乳区前哨淋巴结有转移。1例为蓝染前哨淋巴结无转移而内乳淋巴结有转移。另1例为未检出蓝染的内乳区淋巴结者,其内乳区淋巴结有转移。后2例判定为假阴性。检出率为75.9%,灵敏度为83.3%,特异度为100%,假阴性率为16.7%,准确率为93.1%,阳性预测值100%,阴性预测值89.5%。结论内乳前哨淋巴结可以反映内乳淋巴结的转移状况,内乳前哨淋巴结的检测可以为内乳淋巴结清除提供依据。
Objective To investigate the significance of sentinel lymph node in internal mammary carcinoma and its clinical value. Methods Twenty-nine patients with high risk of internal mammary lymph node metastasis in our hospital were screened by blue dye, followed by clear lymph node dissection and confirmed blue-stained sentinel lymph node in the internal mammary region. Results Twenty-two cases of blue-stained sentinel lymph nodes were detected in 29 patients. The final pathology showed that there were 12 cases of internal mammary lymph node metastasis, of which 8 cases were blue-stained internal mammary sentinel lymph node metastasis and internal mammary lymph node metastasis; 2 cases were only blue-stained internal mammary sentinel lymph node metastasis. One case had blue-stained sentinel lymph node without metastasis and internal mammary lymph node metastasis. The other case was not detected in the blue dye of the internal mammary node, the lymph node metastasis. After 2 cases were judged as false negative. The detection rate was 75.9%, the sensitivity was 83.3%, the specificity was 100%, the false negative rate was 16.7%, the accuracy rate was 93.1%, the positive predictive value was 100% and the negative predictive value was 89.5%. Conclusion Internal sentinel lymph node can reflect the status of internal mammary lymph node metastasis, and detection of internal sentinel lymph node can provide basis for internal mammary lymph node dissection.