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目的:探讨早期乳腺癌前哨淋巴结活检术(SLNB)的可行性及其对腋窝淋巴结分期的预测情况,比较蓝染法与联合法对前哨淋巴结(SLN)的检出率以及患者的临床特征对SLN检出率的影响.方法:回顾性分析2015-07-21/2016-08-25新疆医科大学附属肿瘤医院乳腺外科所实施的190例SLNB患者的临床资料.所有患者中,134例采用放射性核素联合美蓝染色示踪法定位SLN,其余56例采用美蓝染料注射法.如SLN阳性,则继续行腋窝淋巴结清扫术(ALND),如SLN阴性,则根据患者意愿以及其具体情况选择是否行ALND,即“保腋窝”.结果:190例乳腺癌SLNB患者中,成功检出188例,2例未检出,8例假阴性,检出率为98.9%,准确率为94.6%,假阴性率为11.6%.结论:SLNB能准确预测腋窝淋巴结的状态,蓝染法和联合法示踪SLN均能够准确定位SLN,可根据情况选择示踪方法.年龄因素对SLN的检出率及假阴性率有明显影响,施行过程中对年龄≥50岁的患者应尽量采用联合法检测SLN.病灶部位、病灶大小、核素注射部位、病理类型等因素对SLN检出率及假阴性率均无明显影响.
Objective: To investigate the feasibility of sentinel lymph node biopsy (SLNB) in early breast cancer and its prediction on the axillary lymph node staging. To compare the detection rate of sentinel lymph node (SLN) between blue dye method and combined method and the clinical features of patients with SLN Methods: A retrospective analysis of the clinical data of 190 patients with SLNB performed by Department of Breast Surgery, Affiliated Tumor Hospital of Xinjiang Medical University from July 2015 to August 2016 was performed retrospectively.All patients, 134 patients were treated with radionuclide In combination with methylene blue staining tracer, SLN was located and the remaining 56 cases were treated with methylene blue dye injection method. If SLN was positive, axillary lymph node dissection (ALND) was continued. If SLN was negative, according to patients’ wishes and their specific circumstances, Results: 190 cases of SLNB patients with breast cancer were successfully detected in 188 cases, 2 cases were not detected, 8 cases were false negative, the detection rate was 98.9%, the accuracy rate was 94.6% False negative rate was 11.6% .Conclusion: SLNB can accurately predict the status of axillary lymph nodes, blue dye method and SLN combined with tracing method can accurately locate SLN, tracing method can be selected according to the situation.Agents on SLN detection rate and False negative rate has a significant effect on the implementation of the age ≥ The 50-year-old patients should try to detect the SLN by the combination method.The factors such as lesion size, lesion size, nuclide injection site and pathological type have no obvious effect on the SLN detection rate and false negative rate.