摘要
目的探讨将示踪剂行乳晕下注射与肿瘤周围注射检测乳腺癌前哨淋巴结(SLN)的可行性及准确性.方法90例临床上腋窝淋巴结阴性的浸润性乳腺癌.其中40例病人术前于乳晕下注射1.0mci的锝99硫化胶体,术中于乳晕下注射亚甲蓝2ml,同时术中用手握式γ-同位素探测仪确认有放射活性的SLN;行手术解剖法解剖分离出蓝染的SLN.另50例病人于肿瘤周围注射美蓝4～6ml,术中也用解剖法分离出蓝染的SLN.所取SLN单独送病检,相应腋窝行淋巴结清扫并常规病检.结果40例乳晕下注射发现SLN者39例,每例SLN平均数目为(1.3±0.7)枚,检出率为97.5%,SLN病检结果预测淋巴结的准确率为97.4%;假阴性1例,假阴性率为2.6%.50例肿瘤周围注射美蓝的病人中发现SLN者45例,每例SLN平均数目为(2.6±0.9)枚,检出率为90%,SLN病检结果预测淋巴结的准确率为91%;4例假阴性,假阴性率为8.9%.结论本研究提示乳晕下注射锝99硫化胶体加亚甲蓝法比肿瘤周围单纯注射亚甲蓝法确定SLN有较高的准确性.
Objective To investgate the possibility and accuracy of identification of the sentinel lymph node （SLN） in breast carcinoma through subareolar versus peritumoral injection by tracing marker. Methods Ninety patients with operable invasive breast carcinomas and clinically node-negative. Fourty of them were injected with 1.0 mCi of technetium^99 sulfur colloid（unfiltered） at preoperation and 2ml methylene blue dye was injected inoperation in subareolar;radioactive SLNs were identified using a hand-held gamma detector probe,all blue stained SLNs were removed during operation. The other 50 of them were injected 2-4ml methylene blue dye in peritumor during operation,all blue stained lymph nodes found during operation were considered as SLN. All SLNs were removed for pathological examination separately. All patients had axillary lyphadenectomy（ALDN） and routinely pathological examination. Results SLNs were identified in 39 of 40 patients through subareolar injection, with an average of （1.3±0.7） SLNs and identifying rate was 97.5% . Histologic status of SLNs predicted axillary nodes status with an accuracy rate of 97.4 % and false nagative rate is 2.6% （1 cases）. The SLNs were identified in 45 of 50 patients through peritumoral injection, with an average of （2.6 ±0.9） SLNs and identifying rate was of 90%. Histologic status of SLNs predicted axillary nodes status with an accuracy rate of 91% and false nagative rate of 8.9 % （4 cases）. Conclusion Subareolar injection of technetium plus blue dye is more accurate than peritumoral injection of blue dye.
出处
《重庆医学》
CAS
CSCD
2005年第12期1785-1786,共2页
Chongqing medicine
关键词
乳腺癌
前哨淋巴结
示踪剂
breast carcinoma
sentinel lymph node
tracing marker
