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目的探讨乳腺外科医生前哨淋巴结活检术(SLNB)的学习曲线,分析影响学习曲线的因素,以便SLNB在临床上广泛开展。方法以40例临床体检腋窝淋巴结(ALN)阴性,可手术乳腺癌患者作为研究对象,所有患者均单独采用美蓝染色剂作为前哨淋巴结(sentinel lymphnode,SLN)示踪剂,常规行SLNB活检和ALND(腋淋巴结清扫术)。结果本组共有38例患者找到SLN,成功率为95.0%,其中病理报告SLN癌性转移者11例,无转移27例,1例SLN冰冻阴性,常规病理阳性,假阴性率为9.1%(1/11)。SLNB与ALND转移检测比较效果相一致,准确率高,统计无差异性。结论应用美蓝进行SLNB能替代ALND成为临床腋淋巴结阴性早期乳腺癌患者的标准处理模式。
Objective To investigate the learning curve of sentinel lymph node biopsy (SLNB) in breast surgeons and analyze the factors affecting the learning curve so that SLNB can be widely used clinically. Methods 40 patients with negative ALN and operable breast cancer were enrolled in this study. All patients were treated with methylene blue dye as sentinel lymphnode (SLN) tracer alone. All patients underwent routine SLNB biopsy and ALND (Axillary lymph node dissection). Results A total of 38 cases of SLN were found in this study. The success rate was 95.0%. Among them, 11 cases of SLN cancerous metastasis, 27 cases without metastasis, 1 case with SLN frozen negative, and routine pathology with a false negative rate of 9.1% / 11). SLNB and ALND transfer test results are consistent, high accuracy, no statistical differences. Conclusions The application of methylene blue to replace ALND with SLNB has become the standard treatment for patients with clinical stage axillary lymph node negative early breast cancer.