CAJ | 학술논문

目的探讨联合应用术前99mTc-SC SPECT/CT断层融合淋巴显像、术中γ探针与蓝染法在早期乳腺癌前哨淋巴结活检术(SLNB)中的临床应用价值.方法回顾性分析2012年1月至2013年1月行乳腺癌前哨淋巴结活检患者141例的临床资料,术前行99mTc-SC SPECT/CT断层融合淋巴显像、术中应用γ探针与蓝染法(术中探测)联合探测前哨淋巴结(SLN),记录相关临床及病理资料并进行统计分析.结果 141例患者成功检出前哨淋巴结(SLN) 141例,其中术前99mTc-SC SPECT/CT断层融合淋巴显像、术中探测及二者联合对早期乳腺癌SLN的检出率、灵敏度、准确性及假阴性率分别为:59.57％、100％、100％,80.56％、93.48％、95.74％,91.86％、97.87％、98.58％,19.44％、6.52％、4.26％,差异有统计学意义(P＜0.05)；术前SPECT/CT断层融合淋巴显像与术中探测二者联合法能检出更多的SLN,假阳性率为0％,假阴性率明显降低.结论术前SPECT/CT断层融合淋巴显像与术中探测二者联合法具有较高的SLN检出率、灵敏度及准确率,假阳性率0％,假阴性率较低,临床实践中应尽量采用联合法进行SLNB.
목적 탐토연합응용술전99mTc-SC SPECT/CT단층융합림파현상、술중γ탐침여람염법재조기유선암전초림파결활검술(SLNB)중적림상응용개치.방법 회고성분석2012년1월지2013년1월행유선암전초림파결활검환자141례적림상자료,술전행99mTc-SC SPECT/CT단층융합림파현상、술중응용γ탐침여람염법(술중탐측)연합탐측전초림파결(SLN),기록상관림상급병리자료병진행통계분석.결과 141례환자성공검출전초림파결(SLN) 141례,기중술전99mTc-SC SPECT/CT단층융합림파현상、술중탐측급이자연합대조기유선암SLN적검출솔、령민도、준학성급가음성솔분별위:59.57％、100％、100％,80.56％、93.48％、95.74％,91.86％、97.87％、98.58％,19.44％、6.52％、4.26％,차이유통계학의의(P＜0.05)；술전SPECT/CT단층융합림파현상여술중탐측이자연합법능검출경다적SLN,가양성솔위0％,가음성솔명현강저.결론 술전SPECT/CT단층융합림파현상여술중탐측이자연합법구유교고적SLN검출솔、령민도급준학솔,가양성솔0％,가음성솔교저,림상실천중응진량채용연합법진행SLNB.
Objective To study the clinical value of combination of 99mTc-SC SPECT/CT preoperative lymphoscintigraphy,gamma probe (γ-detection) and blue dye detctation in sentinel lymph node biopsy (SLNB) of patients with early-stage breast cancer.Methods The clinical data of 141 patients with early-stage breast cancer in our hospital from Jan.2012 to Jan.2013 were retrospectively analyzed.All the 141 patients underwent sentinel lymph node (SLN) detection by preoperative 99mTc-SC SPECT/CT lymphoscintigraphy.Gamma probe and blue dye (γ-detection) was used to detect the SLN during operation,and the relational clinical and pathological data were recorded and analyzed.Results SLNs were successfully identified in all the 141 cases.The detection rate,sensitivity,accuracy and false negative rates of SLN by SPECT/CT lymphoscintigraphy,intraoperative detection and their combination was 59.57％,100％,100％,80.56％,93.48％,95.74％,91.86％,97.87％,98.58％,19.44％,6.52％,4.26％,and the differences were significant between them(P ＜0.05).Combination group could detect more SLN,and the false negative rate decreased obviously,the false positive rate was 0％.Conclusions Combination group could detect more SLN,it has advantages such as higher detection rate,higher sensitivity and higher accuracy,the false positive rate was 0％,the false negative rates was very low,so the combination of multi-method should be adopted in clinical practice.