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目的 探讨前哨淋巴结活检 (SLNB)对乳腺癌手术导航的临床价值及可靠性。方法 用染料法(1%亚甲蓝 )对 30例乳腺癌病人进行腋窝前哨淋巴结 (SLN)染色切除。术中冰冻切片 ,术后石蜡切片 ,并常规行腋窝淋巴结清除术 (ALND)。结果 SLN染色成功率 96 7% (2 9/ 30 ) ,失败 1例。SLN阳性 10例 ,后站淋巴结有癌转移 6例 (6 0 % ) ,无癌转移 4例 (4 0 % )。SLN阴性 19例 ,其中假阴性 1例 ,后站淋巴结均无癌转移。SLNB评价 :检出率 96 7%、准确率 93 3%、敏感度 90 9%、假阴性率 9 1%、假阳性率 0。结论 只要提高技术水平 ,SLN染料着色和检出率都相对较高 ,对外科术式选择有实际指导意义。相信SLNB取代传统的ALND已为时不远。
Objective To investigate the clinical value and reliability of sentinel lymph node biopsy (SLNB) for surgical navigation of breast cancer. Methods Thirty cases of breast cancer patients underwent axillary lymph node metastasis (SLN) staining by dye method (1% methylene blue). Intraoperative frozen section, postoperative paraffin section, and routine axillary lymph node dissection (ALND). Results The success rate of SLN staining was 96.7% (29/30), and one case failed. SLN positive in 10 cases, posterior lymph node metastasis in 6 cases (60%), no cancer metastasis in 4 cases (40%). Negative SLN in 19 cases, including false negative in 1 case, no lymph node metastasis. Evaluation of SLNB: The detection rate was 96.7%, the accuracy rate was 93.3%, the sensitivity was 90.9%, the false negative rate was 9 1% and the false positive rate was 0. Conclusion As long as the technical level is improved, the coloration and detection rate of SLN dyes are relatively high, which has practical guiding significance for surgical selection. Believe SLNB replace the traditional ALND is not far away.