摘要
目的 探讨手术中用亚甲蓝染色法鉴别乳癌前哨淋巴结 (SLN )的可行性及准确性。方法 术中于癌块周围注射 1%亚甲蓝 4～ 6ml ,5～ 10min后开始手术。凡术中发现被蓝染的淋巴结即认定为SLN ,单独切除送病检 ;相应腋窝行淋巴结清扫 ,所得淋巴结即为非SLN ,亦送常规病检。结果 5 0例中发现SLN者 45例 ,检出率为 90 .0 % ;45例中SLN共计 117枚 ,其中位于第I站淋巴结 111枚 ,占95 .0 % ,位于第II站淋巴结 6枚 ,占 5 .0 %。在鉴别SLN失败的 5例中 ,4例癌块位于下象限 ,仅 1例癌块位于上象限 (P <0 .0 5 ) ,而与癌块大小之间差异无显著意义 (P >0 .0 5 )。SLN病检结果预测腋窝状况的准确率达 91.0 % ;4例SLN病检阴性 ,但非SLN病检阳性 ,假阴性率为 8.9%。结论 术中亚甲蓝染色法能较准确鉴别SLN ;SLN可准确反映乳癌患者腋窝状况。SLN与原发癌瘤的位置有关 ,而与其大小及以前是否行乳腺手术无关。
Objective To investigate the possibility and accuracy of idenfication of the sentinel lymph node(SLN) in breast cancer(BC) by using methylene blue intra operatively.Methods 4～6ml methylene blue dye was injected around the breast mass intra operatively. 5～10 minutes after injection,the operation for BC was performed. All blue stained lymph nodes found during operation were considered as SLN, and removed for pathological examination. All patients had axillary lymphadenectomy(ALDN),and the acquired nonsentinel lymph nodes(NSLN)from them were also examined. Results The SLN were identified in 45 of 50 patients(90.0%).There were all 117 SLNs in this series. Of 117 SLNs,111 were located in stage I lymph nodes in axilla(95.0%),and 6 SLNs in stage II(5.0%). Of the 5 cases of the unidentified SLN,the primary tumor was located in the inferior quadrant in 4 cases,and in the uper quadrant in 1 case (P<0.05), but the size of tumors had no correlation with SLN(P>0.05). Histologic status of the SLNs accurately predicted axillary nodes status with an accuracy rate of 91.0%. 4 cases or SLN examination were negative while their NSLN were positive with false negative rate 8.9%. Conclusions This technique can identify SLN accurately;the histology of SLN can predict axillary status correctly. Sentinel lymph node has correlation with the location of the primary tumor but has no correlation with the size of the tumor or breast operation before.
出处
《中国普通外科杂志》
CAS
CSCD
2002年第6期324-327,共4页
China Journal of General Surgery
