前哨淋巴结阳性早期乳腺癌其腋窝淋巴结转移状况的研究

摘要

目的：探讨早期乳腺癌前哨淋巴结（ sentinel lymphnode ，SLN）阴性患者、1枚阳性SLN患者与2枚以上阳性SLN患者的非前哨淋巴结（ non-sentinel lymphnode，NSLN）转移状况。方法：对90例T1-2N0M0乳腺癌患者应用美蓝为示踪剂行前哨淋巴结活检术（ sentinel lymphnode biopsy，SLNB），进再行常规腋窝淋巴结清扫术（ axillary lymph node dissection，ALND），根据检查结果将患者分成SLN（-）组、SLN（＋）＝1组及SLN（＋）≥2组，并对各组的NSLN阳性率进行比较。结果：32例SLN （-）组检出NSLN阳性1例，阳性率3．1％，39例SLN（＋）＝1组检出NSLN阳性4例，阳性率为10．3％，19例SLN（＋）≥2组检出NSLN阳性9例，阳性率为47．4％，SLNB检查假阴性1例，准确率为96．9％；SLN（＋）＝1组的NSLN阳性率略高于SLN阴性组，但差异无统计学意义P＞0．05；SLN（＋）≥2组患者的NSLN阳性率显著高于SLN（-）组及SLN（＋）＝1组，差异均具有统计学意义P＜0．05。结论：研究结果提示1枚SLN阳性患者可仅行SLNB免行ALND，但≥2枚SLN阳性患者则需常规行ALND。%Objective:To explore the early sentinel lymph node in breast cancer ( sentinel, lymphnode, SLN) non sentinel lymph node negative patients, 1 positive in SLN patients with more than 2 pieces of SLN patients with positive nodes ( non-sentinel lymph-node, NSLN) metastasis.Methods:90 T1-2N0M0 patients with breast cancer using methylene blue as tracer for sentinel lymph node biopsy ( sentinel lymphnode biopsy, SLNB ) , and enter the routine axillary lymphadenectomy ( axillary lymph node dissection, ALND) , according to the test results of the patients were divided into SLN ( -) group, =1 group and SLN ( +) SLN ( +) ≥2 groups, and each group of NSLN positive rates were compared.Results:32 cases of SLN (-) group was 1 cases with positive NSLN, the positive rate was 3.1%, 39 cases of SLN (+) =1 was detected in 4 cases of NSLN positive, the positive rate was 10.3%, 19 ca-ses of SLN (+) ≥2 group were NSLN positive in 9 cases, the positive rate was 47.4%, SLNB examination of 1 cases of false nega-tive, the accuracy rate was 96.9%;the positive rate of SLN (+) NSLN in =1 group was higher than that in SLN negative group, but no significant difference between P0.05;SLN ( +) ≥ NSLN positive rate in patients of the 2 groups were significantly higher than that of SLN (-) group and SLN (+) in =1 group, the differences were statistically significant P0.05.Conclusion:The results suggest that the 1 SLN positive patients can only SLNB free ALND, patients with positive but≥2 SLN requires routine ALND.