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目的:探讨应用亚甲蓝染色法检测乳腺癌新辅助化疗后,前哨淋巴结的准确性和有效性。方法:对2009年1月至2012年12月收治的47例确诊为乳腺癌的患者(新辅助化疗前临床检查腋窝淋巴结可疑癌转移)予4个疗程新辅助化疗,术中行亚甲蓝染料法辅助下腋窝前哨淋巴结活检+腋窝淋巴结清扫+乳腺癌根治术。观察前哨淋巴结的检出率、准确率、灵敏度,假阴性率。结果:44例检出蓝染的前哨淋巴结,平均检出前哨淋巴结(2.5±0.6)枚。前哨淋巴结的检出率、准确率、灵敏度,假阴性率分别为93.6%、93.2%、90.6%、9.4%。前哨淋巴结的检出率或者准确率与新辅助化疗前原发肿瘤大小、区域淋巴结临床分级,或者乳腺癌免疫组化法分型之间无相关性(P>0.05)。结论:乳腺癌新辅助化疗后行亚甲蓝染色法辅助下腋窝前哨淋巴结活检是简便可行的。
Objective: To investigate the accuracy and effectiveness of using methylene blue staining to detect sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer. Methods: A total of 47 patients diagnosed with breast cancer from January 2009 to December 2012 were treated with neoadjuvant chemotherapy (suspicious carcinoma metastasis of axillary lymph node before neoadjuvant chemotherapy). The patients were treated with methylene blue dye Assisted axillary sentinel lymph node biopsy + axillary lymph node dissection + radical mastectomy. Sentinel lymph node detection rate, accuracy, sensitivity, false negative rate. Results: Sentinel lymph nodes were detected in 44 cases with blue stains, and sentinel lymph nodes (2.5 ± 0.6) were detected on average. Sentinel lymph node detection rate, accuracy, sensitivity, false negative rates were 93.6%, 93.2%, 90.6%, 9.4%. There was no correlation between the detection rate or accuracy of sentinel lymph node and the size of primary tumor before neoadjuvant chemotherapy, clinical grade of regional lymph nodes or immunohistochemistry of breast cancer (P> 0.05). Conclusions: Methylene blue staining assisted axillary lymph node biopsy of axillary lymph nodes is a simple and feasible method after neoadjuvant chemotherapy for breast cancer.