CAJ | 학술논문

目的：探讨前哨淋巴结活检术（sentinel lymph node biopsy，SLNB）替代腋窝淋巴结清扫（axillary lymph node dissection，ALND）在早期乳腺癌患者中的应用价值和安全性。方法回顾性分析大连医科大学附属第二医院在2011年6月至2014年6月期间行SLNB和ALND患者术后上肢并发症、腋窝局部复发及远处转移情况。随访至2014年11月，中位随访时间41（18～52）个月。结果 SLNB组术后上肢并发症发生率较ALND组少，差异有统计学意义（麻木疼痛χ2＝18.174，P＝0.000；活动受限χ2＝20.413，P＝0.000；肌力减退χ2＝23.785， P＝0.000，P＜0.05），腋窝局部复发及远处转移率差异无统计学意义（χ2＝0.555，P＝0.516，P＞0.05）。结论在SLN阴性早期乳腺癌中，SLNB可取得与ALND相同的疗效；同时，SLNB与ALND相比手术创伤小，术后并发症少。
목적：탐토전초림파결활검술（sentinel lymph node biopsy，SLNB）체대액와림파결청소（axillary lymph node dissection，ALND）재조기유선암환자중적응용개치화안전성。방법회고성분석대련의과대학부속제이의원재2011년6월지2014년6월기간행SLNB화ALND환자술후상지병발증、액와국부복발급원처전이정황。수방지2014년11월，중위수방시간41（18～52）개월。결과 SLNB조술후상지병발증발생솔교ALND조소，차이유통계학의의（마목동통χ2＝18.174，P＝0.000；활동수한χ2＝20.413，P＝0.000；기력감퇴χ2＝23.785， P＝0.000，P＜0.05），액와국부복발급원처전이솔차이무통계학의의（χ2＝0.555，P＝0.516，P＞0.05）。결론재SLN음성조기유선암중，SLNB가취득여ALND상동적료효；동시，SLNB여ALND상비수술창상소，술후병발증소。
Objective To study the application value and safety of sentinel lymph node biopsy ( SLNB) replacing axillary lymph node dissection ( ALND) for patients with early breast cancer .Methods Data was col-lected for patients undergoing SLNB or ALND in the Second Hospital of Dalian Medical University from June 2011 to June 2014.The complication of upper extremity , axillary local recurrence and distant metastasis were retro-spectively analyzed.The patients were followed up to Nov .2014, with the median follow-up of 41 ( 18-52 ) months.Results Patients undergoing SLNB had less postoperative complications of upper extremity ( numb and painχ2 =18.174, P =0.000;Restricted movement χ2 =20.413, P =0.000; Strength loss χ2 =23.785, P =0.000;P<0.05).There was no statistical difference for the postoperative complications of axillary local recur-rence and distant metastasis (χ2 =0.555, P=0.516; P>0.05).Conclusion In early breast cancer without SLN, SLNB can achieve the equivalent effect to ALND with less damage and complications .