中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2014年
29期
152-154
,共3页
单侧%多发%乳腺癌%前哨淋巴结%腋窝淋巴结清扫
單側%多髮%乳腺癌%前哨淋巴結%腋窩淋巴結清掃
단측%다발%유선암%전초림파결%액와림파결청소
Multifocal%Unilateral%Breast cancer%Sentinel node%Axillary lymphnode dissection
目的：研究前哨淋巴结(sentinel lymph node, SLN)活检术(SLN biopsy, SLNB)对单侧多发乳腺癌(multiple synchronous tumor, MST)患者腋窝淋巴结状态判断的可行性。方法在23例确诊单侧多发乳腺癌患者术中行SLNB，所有患者均行乳腺癌改良根治术，如患者拒绝或者两病灶位于乳房同一象限，改行保乳加腋窝淋巴结清扫术(axillary lymphnode dissection, ALND)。术中不送检SLN，ALND后由手术医师分离出SLN送检。术后对全部淋巴结行连续切片病理检查。结果23例患者有21例完成前哨淋巴结活检术，成功率91.3%。 SLN预测腋窝淋巴结状态的假阴性率、敏感度、准确率分别为15.4%，84.6%，90.5%。结论 SLNB假阴性率高，不推荐在单侧多发乳腺癌患者中实行前哨淋巴结活检。
目的：研究前哨淋巴結(sentinel lymph node, SLN)活檢術(SLN biopsy, SLNB)對單側多髮乳腺癌(multiple synchronous tumor, MST)患者腋窩淋巴結狀態判斷的可行性。方法在23例確診單側多髮乳腺癌患者術中行SLNB，所有患者均行乳腺癌改良根治術，如患者拒絕或者兩病竈位于乳房同一象限，改行保乳加腋窩淋巴結清掃術(axillary lymphnode dissection, ALND)。術中不送檢SLN，ALND後由手術醫師分離齣SLN送檢。術後對全部淋巴結行連續切片病理檢查。結果23例患者有21例完成前哨淋巴結活檢術，成功率91.3%。 SLN預測腋窩淋巴結狀態的假陰性率、敏感度、準確率分彆為15.4%，84.6%，90.5%。結論 SLNB假陰性率高，不推薦在單側多髮乳腺癌患者中實行前哨淋巴結活檢。
목적：연구전초림파결(sentinel lymph node, SLN)활검술(SLN biopsy, SLNB)대단측다발유선암(multiple synchronous tumor, MST)환자액와림파결상태판단적가행성。방법재23례학진단측다발유선암환자술중행SLNB，소유환자균행유선암개량근치술，여환자거절혹자량병조위우유방동일상한，개행보유가액와림파결청소술(axillary lymphnode dissection, ALND)。술중불송검SLN，ALND후유수술의사분리출SLN송검。술후대전부림파결행련속절편병리검사。결과23례환자유21례완성전초림파결활검술，성공솔91.3%。 SLN예측액와림파결상태적가음성솔、민감도、준학솔분별위15.4%，84.6%，90.5%。결론 SLNB가음성솔고，불추천재단측다발유선암환자중실행전초림파결활검。
Objective To evaluate the feasibility of SLNB for predicting the status of axillary lymph node and determin-ing the extent of axillary dissection in preoperatively diagnosed multiple unilateral synchronous breast cancers. Methods A total of 23 MST patients of clinical negative axillae diagnosed by core needle biopsy were studied. SLN was localized by injecting methylene blue. No intraoperative pathological examination. All patients with MST were eligible for initial breast surgery (radical modified mastectomy or conservative surgery+ALND). To choose radical modified mastectomy unless MST was limited to two foci in the same quadrant or patient's opposition for total mastectomy). Sentinel lymph nodes (SLNs) were submitted to pathological doctor after ALND. All lymph nodes were valuated pathologically after operation. Results Of 23 patients, 21 cases were assessable. The SLNB-identified rate was 91.3%. The false-negative rate(FNR)was 15.4%, the accuracy rate was 90.5%, and the sensitivity was 84.6%. Conclusion With a high FNR,we do not recommend SLNB as a routine procedure for MST.
