CAJ | 학술논문

目的探讨早期乳腺癌更为合理的腋窝淋巴结处理方法,明确腋窝可疑淋巴结取样结合前哨淋巴结活检(SLNB)替代单纯SLNB时的假阴性率是否明显降低,为临床应用提供依据.方法采用传统的腋窝淋巴结外科学分群方法,对符合入组条件的42例早期乳腺癌患者术前行B超引导下钩丝定位,术中行腋窝SLNB和定位的可疑淋巴结活检,再行全腋窝淋巴结清扫(ALND)或level II水平的腋淋巴结清扫,对SLN、可疑淋巴结、腋窝其余的淋巴结分3组行病理检查,比较单纯SLNB与SLNB配合可疑淋巴结取样活检预测腋淋巴结状态的差异.结果 SLNB总成功率为100%(42/42),SLNB 2例假阴性,假阴性率11%(2/18),敏感性88.9%(16/18),准确率95.2%(40/42).SLNB配合可疑淋巴结活检预测腋淋巴结状态未见假阴性,敏感性100%(18/18),准确率100%(42/42).结论超声引导可疑淋巴结钩丝定位取样有降低乳腺癌SLNB假阴性率的趋势,但本组样本数少,差异无统计学意义(P=0.250 0).
목적 탐토조기유선암경위합리적액와림파결처리방법,명학액와가의림파결취양결합전초림파결활검(SLNB)체대단순SLNB시적가음성솔시부명현강저,위림상응용제공의거.방법 채용전통적액와림파결외과학분군방법,대부합입조조건적42례조기유선암환자술전행B초인도하구사정위,술중행액와SLNB화정위적가의림파결활검,재행전액와림파결청소(ALND)혹level II수평적액림파결청소,대SLN、가의림파결、액와기여적림파결분3조행병리검사,비교단순SLNB여SLNB배합가의림파결취양활검예측액림파결상태적차이.결과 SLNB총성공솔위100%(42/42),SLNB 2례가음성,가음성솔11%(2/18),민감성88.9%(16/18),준학솔95.2%(40/42).SLNB배합가의림파결활검예측액림파결상태미견가음성,민감성100%(18/18),준학솔100%(42/42).결론 초성인도가의림파결구사정위취양유강저유선암SLNB가음성솔적추세,단본조양본수소,차이무통계학의의(P=0.250 0).
Objective To explore ideal surgical axillary management of early breast cancer,and to determine the feasibility of reducing false negative rate of sentinel lymph node biopsy(SLNB)by combination of axillary suspicious lymph node biopsy and SLNB.Methods From Jan.2008 to Oct.2009,42 consecutive cases with early breast cancer were enrolled.All patients underwent suspicious node hook-wire location by doppler ultrasonography before operation.SLNB and suspicious lymph node biopsy were performed during operation.Complete axillary nodes dissection(ALND)or level II dissection would be conducted according to the biopsy result.The difference of node status prediction between SLNB and SLNB with axillary suspicious lymph node biopsy and was compared.Results All the 42 cases successfully underwent SLNB (100%).There were 2 false negatives occurred in SLNB,resulting in false negative rate of 11%,sensitivity of 88.9%and accuracy of 95.2%in predicting axillary nodes status.By contrast,SLNB with axillary suspicious node biopsy showed a false-negative rate of 0%,sensitivity of 100%,and accuracy of 100%.Conclusions Compared to SLNB in early breast cancer,combination of suspicious node biopsy and SLAB has a tendency of reducing false negative rate.However,Because of the limited samples,the difference has no statistical significance(P=0.2500).