乳腔镜前哨淋巴结活检及腋窝淋巴结清扫的临床研究

摘要

目的:探讨乳腺癌在乳腔镜下行前哨淋巴结活检及腋窝淋巴结清扫的可行性.方法:通过亚甲蓝示踪对40例Ⅰ、Ⅱ期乳腺癌行乳腔镜前哨淋巴结活检(ESLNB),然后行乳腔镜腋窝淋巴结清扫(EALND),对获得的全部淋巴结行病理检查HE染色,确定前哨淋巴结(SLN)检出率、假阴性率等.结果:40例乳腺癌患者SLN检出率为97.44%(39/40),准确率为94.87%(37/39),灵敏度为94.74%(18/19),假阴性率5.26%(1/19);每例平均前哨淋巴结活检(SLNB)检出数目1-6枚,腋窝淋巴结清扫(ALND)检出数目10-29枚.结论:应用乳腔镜下前哨淋巴结活检和腋窝淋巴结清扫准确可行,美容效果好,并发症低,可对早期乳腺癌进行准确腋窝淋巴结分期.%Objective:To evaluate the feasibility of endoscopically axillary sentinel lymph node biopsy and axillary lymph node dissection for breast cancer. Methods: Forty patients with stage Ⅰ or Ⅱ breast cancer were enrolled in this study. Endoscopic biopsy of the axillary sentinel lymph node with methylene blue was performed on the patients, followed by endoscopic axillary lymph node dissection. Pathological examination of the sentinel lymph nodes and axillary lymph nodes was made with HE . The detection rate and false negative rate were ascertained. Results: Among 40 patients, the SLN detection rate was 97.44 ％ ( 39/40 ), the accuracy rate was 87.18％( 34/39 ), sensitivity rate was 94.74％( 18/19 ), false negative rate was 5.26％( 1/19 ). The average ALN number was 13.40. The average SLN number was 3.53. Conclusion: Endoscopic axillary sentinel lymph node biopsy and axillary lymph node dissection are accurate and reliable with little complication. It can has good efficiency of cosmetic and lower complications.It can provide accurate lymph node stages.