CAJ | 학술논문

目的:染料法是乳腺癌前哨淋巴结活检的方法之一,其成功率受多种因素影响.本研究旨在探讨影响染料法乳腺癌前哨淋巴结活检成功率的相关因素.方法:2007年1月-2008年8月乳腺癌患者141例,于乳晕周围注射1%亚甲蓝,实施前哨淋巴结活检,随后行腋窝淋巴结清扫,常规HE染色进行病理诊断.采用非条件logistic回归进行单因素和多因素分析.结果:126例患者检出前哨淋巴结,15例检测失败.前哨淋巴结活检成功率89.4%,假阴性率为6.82%.单因素分析结果显示,活检成功率与患者年龄、体质量指数(body mass index,BMI)、肿瘤大小、术前腋窝淋巴结状态、肿瘤分级及腋窝淋巴结阳性数≥4枚显著相关.多因素分析结果显示,年龄(OR=4.587,P=0.024)、BMI(OR=4.882,P=0.011)及腋窝淋巴结阳性数≥4枚(OR=3.143,P=0.013)是前哨淋巴结活检成功率的独立影响因素.结论:亚甲蓝示踪法是乳腺癌前哨淋巴结活检的可靠方法,其成功率与患者年龄、BMI和腋窝淋巴结转移数相关.
목적:염료법시유선암전초림파결활검적방법지일,기성공솔수다충인소영향.본연구지재탐토영향염료법유선암전초림파결활검성공솔적상관인소.방법:2007년1월-2008년8월유선암환자141례,우유훈주위주사1%아갑람,실시전초림파결활검,수후행액와림파결청소,상규HE염색진행병리진단.채용비조건logistic회귀진행단인소화다인소분석.결과:126례환자검출전초림파결,15례검측실패.전초림파결활검성공솔89.4%,가음성솔위6.82%.단인소분석결과현시,활검성공솔여환자년령、체질량지수(body mass index,BMI)、종류대소、술전액와림파결상태、종류분급급액와림파결양성수≥4매현저상관.다인소분석결과현시,년령(OR=4.587,P=0.024)、BMI(OR=4.882,P=0.011)급액와림파결양성수≥4매(OR=3.143,P=0.013)시전초림파결활검성공솔적독립영향인소.결론:아갑람시종법시유선암전초림파결활검적가고방법,기성공솔여환자년령、BMI화액와림파결전이수상관.
Objective: Blue dye was one of the methods for sentinel lymph node biopsy in breast cancer, but the success rate was affected by multiple factors. This study was to determine the related factors contributing to the success of sentinel lymph node biopsy in breast cancer using blue dye method. Method:From Jan. 2007 to Aug.2008, sentinel lymph node biopsy was performed by periareolarly injecting 1% methylene blue in 141 breast cancer patients followed by axillary clearance. Pathological diagnosis was performed for all of the lymph nodes by conventional HE staining. Unconditional logistic regression was applied to make both univariate and multiva-riate analysis. Results:Sentinel lymph node was successfully detected in 126 patients. But the biopsy was failed in the 15 patients. The success rate was 89.4% and the false negative rate was 6.82%. Univariate analysis showed that success rate of biopsy was in association with patients' age, body mass index (BMI), tumor size, preoperative axillary node's status, pathological grade as well as ≥4 positive axillary lymph nodes involved. Multivariate analysis indicated that the patients'age (OR=4.587, P=0.024), BMI (OR=4.882, P=0.011) as well as 4 or more of the axillary nodes involved (OR=3.143, P=0.013) were independent predicting factors for the success of sentinel lymph node biopsy. Conclusions:Methylene blue dyeing is a reliable method for sentinel lymph node biopsy. The rate of success is associated with patients' age, BMI as well as the number of metastases in axillary lymph nodes.