CAJ | 학술논문

目的对乳腺癌前哨淋巴结活组织检查(SLNB)术中诊断常用的方法印片细胞学(TIC)及冷冻切片(FS)术中联合应用的价值进行评估.方法 150例患者的400枚前哨淋巴结(SLN),将其中352枚SLN沿长轴对分,两切面分别印片,行术中TIC及FS诊断,其余48枚较小的SLN仅行FS诊断,结果与术后病理进行比较.结果 55例患者的89枚SLN为阳性.TIC及FS特异度均为100%.按SLN数目统计,TIC和FS术中诊断的敏感度分别为71.9%(64/89)和83.1%(74/89)(P＞0.05);两者联合诊断的敏感度为96.6%(86/89),显著高于FS和TIC单独诊断的敏感度(均P＜0.001).按患者数目统计,TIC及FS术中诊断的敏感度分别为80.0%(44/55)及81.8%(45/55)(P＞0.05),两者联合诊断的敏感度为94.5%(52/55),显著高于FS和TIC单独诊断的敏感度(均P＜0.001).结论联合应用FS及TIC进行SLN术中诊断具有较高的敏感度和特异度,能够满足临床需求,可以有效地避免二次手术.
목적 대유선암전초림파결활조직검사(SLNB)술중진단상용적방법인편세포학(TIC)급냉동절편(FS)술중연합응용적개치진행평고.방법 150례환자적400매전초림파결(SLN),장기중352매SLN연장축대분,량절면분별인편,행술중TIC급FS진단,기여48매교소적SLN부행FS진단,결과여술후병리진행비교.결과 55례환자적89매SLN위양성.TIC급FS특이도균위100%.안SLN수목통계,TIC화FS술중진단적민감도분별위71.9%(64/89)화83.1%(74/89)(P＞0.05);량자연합진단적민감도위96.6%(86/89),현저고우FS화TIC단독진단적민감도(균P＜0.001).안환자수목통계,TIC급FS술중진단적민감도분별위80.0%(44/55)급81.8%(45/55)(P＞0.05),량자연합진단적민감도위94.5%(52/55),현저고우FS화TIC단독진단적민감도(균P＜0.001).결론 연합응용FS급TIC진행SLN술중진단구유교고적민감도화특이도,능구만족림상수구,가이유효지피면이차수술.
Objective Frozen section(FS)and touch imprint cytology(TIC)were common methods for intraoperative evaluation of sentinel lymph node(SLN)biopsy in breast cancer,with low sensitivity when used separately.The purpose of this study was to evaluate the value of combination of these two techniques.Methotis This study included 400 sentinel nodes from 150 patients with breast cancer.352 sentinel nodes were bisected along the long axis.Each sectioned surface of SLN was imprinted onto the surface of a slide and was analyzed by cytologist;meanwhile SLN were analyzed with intraoperative FS.The other 48 SLN were only analyzed with intraoperative PS due to their small size.Results of intraoperative P3 and TIC were compared with final pathology.Results Eighty-nine positive SLN from 55 patients were identified by final pathology.The specificity of FS and TIC were both 100%.According to the number of SLN.the sensitivity of TIC and FS was 71.9%(64/89)and 83.1%(74/89),respectively(P＞0.05).The sensitivity of TIC compared with FS was 96.6%(86/89),significantly higher than that of TIC and FS separately(both P＜0.001).According to the number of patients,the sensitivities of TIC and FS were 80.0%(44/55)and 81.8%(45/55),respectively(P＞0.05).The sensitivity of TIC compared with FS was 94.5%(52/55).significantly higher than that of TIC and FS separately (both P＜0.001).Conclusion Combination of FS and TIC for the intraoperative diagnosis of SLN biopsy in breast cancer was reliable,with hish sensitivity and specificity,and could avoid the second axillary operation efficiently.