摘要
目的 探讨乳腺癌术中冰冻切片在乳腺癌前哨淋巴结中的诊断价值.方法 选取我院2016年1月至2018年12月收治的50例腋窝淋巴结临床诊断结果 为阴性的乳腺癌患者为研究对象.在其接受乳腺癌根治手术治疗前,采用4 mL浓度为0.5%的亚甲蓝溶液作为示踪剂成功检出前哨淋巴结,手术中确定并单独活检前哨淋巴结,所有的前哨淋巴结均行手术冰冻切片,术后对前哨淋巴结进行常规石蜡切片检查,对于冰冻切片呈现阴性的前哨淋巴结同时进行连续切片检查.分析冰冻切片检查前哨淋巴结的特异度和灵敏度.结果本组50例患者中成功检出前哨淋巴结者50例,检出率为100.00%.50例患者共取出淋巴结1077枚,取出前哨淋巴结136枚.手术后石蜡切片病理诊断前哨淋巴结阳性10例,阴性40例,其中2例患者的前哨淋巴结检查结果为阴性但是经过后期诊断为阳性,即为假阴性.手术中冷冻切片前哨淋巴结的阳性率为20.00%(10/50),手术后石蜡切片病检前哨淋巴结的阳性率为20.00%(10/50),手术中冰冻切片对前哨淋巴结癌转移诊断的特异度和灵敏度均为100.00%.手术后对40例阴性前哨淋巴结(石蜡切片检查)实施连续切片检查后发现7例前哨淋巴结微转移,前哨淋巴结阳性率为34.00%(17/50),手术中前哨淋巴结冰冻切片检测前哨淋巴结转移的灵敏度和特异度分别为58.82%和100.00%.结论 手术中冰冻切片是一种特异度高、经济实惠、安全性高、简单易操作以及快速的诊断方法,前哨淋巴结组织量小,手术中通过多点取材和多剖面取材可有效提高微转移的检出率,从而降低乳腺癌前哨淋巴结活检的假阴性率,值得临床应用推广.
Objective To investigate the diagnosis value of breast cancer intraoperative frozen section on sentinel lymph nodes in breast cancer. Methods A total of 50 breast cancer patients with negative clinical diagnosis of axillary lymph nodes admitted in our hospital from January 2016 to December 2018 were selected as the study objects. Before radical mastectomy, sentinel lymph nodes were successfully detected with 4 mL 0.5% methylene blue solution as tracer, during operation, sentinel lymph nodes were identified and biopsied separately, all sentinel lymph nodes were given frozen section,after operation, the sentinel lymph nodes were examined by routine paraffin section, and the negative sentinel lymph nodes were examined by continuous section. The specificity and sensitivity of sentinel lymph nodes detected by frozen section were analyzed. Results Sentinel lymph nodes were successfully detected in 50 patients, and the detection rate was 100.00%. A total of 1 077 lymph nodes and 136 sentinel lymph nodes were removed from 50 patients. After operation, the pathological diagnosis of sentinel lymph nodes by paraffin section showed positive in 10 cases and negative in 40 cases,and the results of sentinel lymph node examination were negative in 2 patients but positive in later diagnosis, which was false negative. The positive rate of sentinel lymph node was 20.00%(10/50) in intraoperative frozen section and 20.00%(10/50) in paraffin section after operation, the specificity and sensitivity of intraoperative frozen section in the diagnosis of sentinel lymph node cancer metastasis were 100.00%. After 40 cases of negative sentinel lymph nodes(paraffin section)were examined by serial section after operation, 7 cases of sentinel lymph nodes micrometastasis were found, the positive rate of sentinel lymph nodes was 34.00%(17/50), the sensitivity and specificity of intraoperative frozen section of sentinel lymph nodes metastasis were 58.82% and 100.00% respectively. Conclusion Intraoperative frozen section is a high-specificity, economical, safe, simple, easy to operate and rapid diagnosis method, the amount of sentinel lymph node tissue is less, and multiple points of material and multi-section materials during surgery can effectively improve the rate of micrometastasis detection, thereby reducing the false negative rate of sentinel lymph node biopsy in breast cancer, which is worthy of clinical application and promotion.
作者
雷芹
钟璧璟
LEI Qin;ZHONG Bi-jing(Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,China)
出处
《临床医学研究与实践》
2019年第33期111-113,共3页
Clinical Research and Practice
关键词
乳腺癌
前哨淋巴结
冰冻切片
石蜡切片
breast cancer
sentinel lymph node
frozen section
paraffin section
