CAJ | 학술논문

目的通过对国内近年来有关乳腺癌前哨淋巴结活检术(SLNB)文献的统计与分析,了解国内前哨淋巴结活检术在乳腺癌治疗中的研究及应用现状.方法以国内公开发行的期刊为依据,以"乳腺肿瘤(breast tumor)"、"前哨淋巴结(SLN)"、前哨淋巴结活检术(SLNB)"为关键词,文献截取时间为1999年1月至2005年12月,通过中国生物医学文献数据库(CBM)、万方数据库和CNKI检索系统进行检索.对检出的文献进行筛选,共入选与乳腺癌前哨淋巴结活检研究相关的88篇论著类文献,增加2篇新近与乳腺癌前哨淋巴结活检研究相关文献.采用SPSS 10.0统计学分析软件进行统计前哨淋巴结活检的成功率,准确性,假阴性率及灵敏度等指标.结果所有患者(共6282例)SLNB检出成功率为90.82%(5705/6282),总体假阴性率为9.69%(259/2671).前哨淋巴结对腋窝淋巴结状况预测的总体敏感性、特异性、假阳性率、准确性、阴性预测值及阳性预测值分别为90.30%、99.64%、0.41%、86.52%、92.11%及99.55%.结论 SLNB能够准确预测腋窝淋巴结的转移状况;SLNB检出率与患者年龄和肿瘤部位有相关性,检出率和假阴性率均与示踪剂注射部位无关,联合法具有较高的检出率和较低的假阴性率;SLN更有可能是乳房整个器官的SLN,而非乳房某个具体部位的SLN,SLN的解剖学定位是固定的,与示踪剂注射的部位无关,也即与原发肿瘤的部位无关.
목적 통과대국내근년래유관유선암전초림파결활검술(SLNB)문헌적통계여분석,료해국내전초림파결활검술재유선암치료중적연구급응용현상.방법 이국내공개발행적기간위의거,이"유선종류(breast tumor)"、"전초림파결(SLN)"、전초림파결활검술(SLNB)"위관건사,문헌절취시간위1999년1월지2005년12월,통과중국생물의학문헌수거고(CBM)、만방수거고화CNKI검색계통진행검색.대검출적문헌진행사선,공입선여유선암전초림파결활검연구상관적88편론저류문헌,증가2편신근여유선암전초림파결활검연구상관문헌.채용SPSS 10.0통계학분석연건진행통계전초림파결활검적성공솔,준학성,가음성솔급령민도등지표.결과 소유환자(공6282례)SLNB검출성공솔위90.82%(5705/6282),총체가음성솔위9.69%(259/2671).전초림파결대액와림파결상황예측적총체민감성、특이성、가양성솔、준학성、음성예측치급양성예측치분별위90.30%、99.64%、0.41%、86.52%、92.11%급99.55%.결론 SLNB능구준학예측액와림파결적전이상황;SLNB검출솔여환자년령화종류부위유상관성,검출솔화가음성솔균여시종제주사부위무관,연합법구유교고적검출솔화교저적가음성솔;SLN경유가능시유방정개기관적SLN,이비유방모개구체부위적SLN,SLN적해부학정위시고정적,여시종제주사적부위무관,야즉여원발종류적부위무관.
Objective To explore the studies and application status of sentinel lymph node biopsy (SLNB) in breast cancer in China by statistically analyzing the relevant domestic literature.Methods The literatures published from January 1999 to December 2005 were searched in the databases of ChinaInfo,CBM and CNKI retrieval system with "breast tumor,SLN and SLNB" as the key words.A total of 88 manuscripts were selected with 2 new reports of SLNB.The successful rate,accuracy,false-negative rate and sensitivity of SLNB were analyzed by SPSS 10.0 statistical analysis software.Results Among a total of 6282 patients,the detection rate of SLNB was 90.82%(5705/6282) and the overall false-negative rate 9.69%(259/2671 ).The prediction sensitivity,specificity,false positive rate,accuracy,negative and positive predictive value of SLN for axillary lymph nodes status were 90.30%,99.64%,0.41%,86.52%,92.11% and 99.55% respectively.Conclusion SLNB can accurately predict the axillary lymph node metastasis.And its detection rate is correlated with patient age and tumor location.The detection rate and false-negative rate has nothing to do with the tracer injection site.A combined regimen has a higher detection rate and a low false negative rate.Affecting the whole breast,SLN is not correlated with a particular area of breast.The validation phase of SLNB in breast cancer is currently feasible in China.