亚甲蓝染色法前哨淋巴结活检应用于肿块切除术后乳腺癌的可行性分析
摘要
目的探讨亚甲蓝染色法前哨淋巴结活检(SLNB)在肿块切除活检术后乳腺癌中应用的可行性及安全性。方法选择早期浸润性乳腺癌患者35例为研究对象,均为乳房肿物切除活检术后患者,临床分期为T1～2N0M0,以亚甲蓝为示踪剂行SLNB后再行腋窝淋巴结清扫术(ALND)。结果 35例患者均成功检出前哨淋巴结,检出率100%,其中SLNB的灵敏度为90.48%,特异度为85.71%,阳性预测值为90.48%,阴性预测值为85.71%,总准确度为88.57%。结论对于早期乳腺癌,乳腺肿块活检术后选择美蓝作为示踪剂行SLNB具有较高的检出率、准确性及临床应用价值。
引文
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[2]Halsted WS.The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June,1889,to January,1894[J].Ann Surg,1894,20(5):497-555.
[3]Giuliano AE,Kirgan DM,Guenther JM,et al.Lymphatic mapping and sentinel lymphadenectomy for breast cancer[J].AnnSurg,1994,220(3):391-401.
[4]Boughey JC,Suman VJ,Mittendorf EA,et al.Factors affecting sentinel lymph node identification rate after neoadjuvant chemotherapy for breast cancer patients enrolled in ACOSOG Z1071(Alliance)[J].Ann Surg,2015,261(3):547-552.DOI:10.1097/SLA.0000000000000551.
[5]Lin PP,Allison DC,Wainstock J,et al.Impact of axillarylymph node dissection on the therapy of breast cancer patients[J].J Clin Oncol,1993,11(8):1536-1544.DOI:10.1200/JCO.1993.11.8.1536.
[6]王杰,王昕,王文彦,等.乳腺肿物局部切除术后乳腺癌前哨淋巴结活检的可行性分析[J],中华肿瘤杂志,2016,38(7):548-550.DOI:10.3760/cma.j.issn.0253-3766.2016.07.013.
[7]吴炅,沈镇宙.乳腺癌前哨淋巴结活检的研究现状与评价[J].中国癌症杂志,2005,15(5):417-421.
[8]刘哲斌,吴炅,黄晓燕,等.乳腺癌前哨淋巴结活检中亚甲蓝与亚甲蓝、同位素联合示踪的比较研究[J].中华普通外科杂志,2007,2(11):840-843.DOI:10.3760/j.is sn:1007-631X.2007.11.01.
[9]劳玲玲,黄小娥,吕峰,等.早期乳腺癌肿块切除行病理活检后前哨淋巴结活检的可行性研究[J].现代实用医学,2018,30(1):67-68.
[10]Wong SL,Edwards MJ,Chan C,et al.Sentinel lymph node biopsy for breast cancer:impact of the number of sentinel nodes removed on the false-negative rate[J].J Amcoil Surg,2001,192(6):684-689.
[11]Albertini JJ,Lyman GH,Cox C,et al.Lymphatic mapping and sentinel lymph node biopsy in the patient wilth breast cancer[J].Am med Assoc,1996,276(22):1818-1822.