摘要
目的 探讨影响乳腺癌哨兵淋巴结活检 (sentinellymphnodebiopsy ,SLNB)成功率和假阴性率的因素。 方法 用美蓝(methyleneblue)作为示踪剂 ,对 330例术前临床分期为T1～T2 N0 M0 的女性原发乳腺癌患者行SLNB ,活检后立即行改良根治术或保乳手术。按病例入组时间的先后 ,将本研究分为 3组 :A组为第 1～ 10 0例 ;B组为第 10 1～ 2 0 0例 ;C组为第 2 0 1～330例。Binary回归分析某些因素 (患者的年龄、肿瘤的部位、腋淋巴结状况以及医师对SLNB的熟练程度等 )与成功率和假阴性率的相关性。结果 330例患者中成功发现哨兵淋巴结的有 2 87例 ,成功率为 87.0 %。A、B、C 3组的成功率分别为79 .0 %、87.0 %和 93.1%。哨兵淋巴结活检的准确率为 89.5 % ( 2 5 7/ 2 87) ,假阴性率为 10 .5 % ( 30 / 2 87)。BinaryLogistic回归分析显示腋淋巴结状况、肿瘤部位和医生的熟练程度是影响发现率重要因素 (P均 <0 .0 5 )。结论 腋淋巴结状况和肿瘤部位是影响乳腺癌SLNB发现率重要的临床病理因素 ,医生对SLNB的熟练程度也对SLNB发现率有较大的影响。
Objective To study the factors that affect detection rate and false negative rate of sentinel lymph node biopsy in breast cancer.Methods We performed sentinel lymph biopsy (SLNB) in 330 patients with breast carcinoma of clinical stage T 1-T 2 N 0 M 0 by using 1% methylthionium blue dye.After the biopsy,patients underwent modified radical mastectomy or breast conservative surgery immediately.The patients were divided into three arms according to the time order of the patients entering the study.A group,1st―100th patients.B group,101st―200th patients.C group,201st―330th patients.Relationship between the detection rate,false negative rate and multifactor (age,tumor size,tumor location,body mass index,breast size,pathologic type,axillary lymph node status and the skill of the doctors in performing SLNB) was analyzed with binary logistic regression.Results SLN of 287 patients was successfully identified in 330 patients.The detection rate was 87.0%.The detection rate of A group,B group and C group were 79.0%,87.0% and 93.1% respectively.The accuracy rate of SLN to predict axillary lymph node status was 89.5% (257/287), and false negative rate was 10.5% (30/287).Multifactor analysis (binary logistic regression) showed that tumor location,axillary lymph node status and skill of the doctors affected the detection rate in SLNB significantly ( P < 0.05 ).Conclusion Tumor location and axillary lymph node status are important clinically pathological factors that affect the detection rate in SLNB of breast cancer.Skill of the doctors who perform SLNB is another important factor.
出处
《肿瘤》
CAS
CSCD
北大核心
2004年第4期396-398,共3页
Tumor
关键词
乳腺肿瘤
淋巴转移
淋巴结
活组织检查
回归分析
Breast neoplasms
Lymphatic metastasis
Lympy nodes
Biopsy
Regression analysis
