中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2008年
5期
343-346
,共4页
周雷%宋新%鲁瑶%刘治滨%李启东%王文跃%王正康%贾振庚%高島茂树
週雷%宋新%魯瑤%劉治濱%李啟東%王文躍%王正康%賈振庚%高島茂樹
주뢰%송신%로요%류치빈%리계동%왕문약%왕정강%가진경%고도무수
乳腺肿瘤%前哨淋巴结活组织检查%肿瘤转移
乳腺腫瘤%前哨淋巴結活組織檢查%腫瘤轉移
유선종류%전초림파결활조직검사%종류전이
Breast neoplasms%Sentinel lymph node biopsy%Neoplasm metastasis
目的 评价连续切片及免疫组化技术在乳腺癌前哨淋巴结(SLN)转移诊断中的价值,探讨微转移和孤立癌细胞的临床意义.方法 对80例腋窝淋巴结阴性的乳腺癌患者,用99mTc-SC和异硫蓝联合法进行前哨淋巴结活检(SLNB),对所有SLN和非SLN进行常规HE染色及免疫组织化学分析.结果 78例(97.5%)成功检出SLN,其中76.5%的SLN同位素和染料检查均为阳性.32例(41%)SLN转移阳性,其中13例(40.6%)为微转移.共有14例(43.8%)患者SLN是惟一阳性的淋巴结.SLN预测腋窝状态的敏感性、特异性和准确性分别为96.9%,100%和98.7%.SLN转移的患者,其SLN之外的转移率明显高于仅有微转移的患者(78.9%vs.23.1%).结论 连续切片及免疫组化技术是乳腺癌SLN转移诊断的敏感方法.仅有SLN微转移患者的SLN之外的腋窝淋巴结转移率低,但其预后意义及对手术方案的影响尚待进一步研究.
目的 評價連續切片及免疫組化技術在乳腺癌前哨淋巴結(SLN)轉移診斷中的價值,探討微轉移和孤立癌細胞的臨床意義.方法 對80例腋窩淋巴結陰性的乳腺癌患者,用99mTc-SC和異硫藍聯閤法進行前哨淋巴結活檢(SLNB),對所有SLN和非SLN進行常規HE染色及免疫組織化學分析.結果 78例(97.5%)成功檢齣SLN,其中76.5%的SLN同位素和染料檢查均為暘性.32例(41%)SLN轉移暘性,其中13例(40.6%)為微轉移.共有14例(43.8%)患者SLN是惟一暘性的淋巴結.SLN預測腋窩狀態的敏感性、特異性和準確性分彆為96.9%,100%和98.7%.SLN轉移的患者,其SLN之外的轉移率明顯高于僅有微轉移的患者(78.9%vs.23.1%).結論 連續切片及免疫組化技術是乳腺癌SLN轉移診斷的敏感方法.僅有SLN微轉移患者的SLN之外的腋窩淋巴結轉移率低,但其預後意義及對手術方案的影響尚待進一步研究.
목적 평개련속절편급면역조화기술재유선암전초림파결(SLN)전이진단중적개치,탐토미전이화고립암세포적림상의의.방법 대80례액와림파결음성적유선암환자,용99mTc-SC화이류람연합법진행전초림파결활검(SLNB),대소유SLN화비SLN진행상규HE염색급면역조직화학분석.결과 78례(97.5%)성공검출SLN,기중76.5%적SLN동위소화염료검사균위양성.32례(41%)SLN전이양성,기중13례(40.6%)위미전이.공유14례(43.8%)환자SLN시유일양성적림파결.SLN예측액와상태적민감성、특이성화준학성분별위96.9%,100%화98.7%.SLN전이적환자,기SLN지외적전이솔명현고우부유미전이적환자(78.9%vs.23.1%).결론 련속절편급면역조화기술시유선암SLN전이진단적민감방법.부유SLN미전이환자적SLN지외적액와림파결전이솔저,단기예후의의급대수술방안적영향상대진일보연구.
Objective The purpose of this study was to assess the value of serial sectioning and immunohistoehemistry(IHC)for the diagnosis of senfinel lymph node(SLNs)metastases in patients with breast cancer,and to evaluate the significance of mierometastases and isolated tunlor cells(ITCs)in the SLNs. Methods Eighty pailents with clinically node-negative breast cancer underwent SLN biopsy with both99mTc-labeled sulfur colloid and iBosulfan blue dye for SLN identification.All SLNS and non-SLNs were evalnated with standard H&E stain and IHC analysis. Results SLNs were successfully identified in 78 of 80 patients(97.5%),the isotope/blue dye concordanee rate was 76.5%for all SLNs.Thirty two patients (41%)had histologically positive SLNs,and 13(40.6%)of these patients hod SLNS with micrometastatic disease.In 14(43.8%)of these patients,the SLNs were the only nodes involved.The sensitivity,specificity and accuracy of SLN biopsy in predicting axillary node stams were 96.9%,100%and 98.7%,reslaeetively.Patients with positive SLNs metastasis had a markedly higher proportion of non-SLNs metastases compared with those with only micrometastasis in the SLNS(78.9% vs 23.1%). Conclusions Serial sectioning and IHC ale sensitive methods for detecting breast cancer metastases in SLNS.The incidence of non-SLNs metastases is rather low in patients with SLNs that contain only micrometsstatic foci and ITCs.The prognostic significance and effect on surgical management of these occult disease have yet to be determined.