摘要
目的 探讨用核素显像联合染料法探测前哨淋巴结 (SLN)及其在乳腺癌外科治疗中的作用。方法 乳腺癌患者 332例 ,均为女性。用99Tcm 硫胶体 (SC)显像联合蓝染料法 ,与单独使用蓝染料法对比 ,进行SLN检出率比较 ,并判断以SLN病理结果推断腋窝淋巴结 (ALN)累及状况的可行性 ;同时对 2 5例患者进行前哨淋巴结活检术 (SLNB)替代全腋窝淋巴结切除术 (ALND)的前瞻性研究。结果 SLNB成功率为 97.8% (32 5 332例 ) ,准确性为 94 .2 % ,假阴性率为 14 .0 % ,其中单纯蓝染料法分别为 96 .7% ,92 .2 %和 2 1.6 % ,联合法分别为 10 0 % ,97.5 %和 4 .8% ,2种方法比较差异均有显著性 (u =1.97和 1.96 5 ,χ2 =7.91,P <0 .0 5 ,0 .0 5和 0 .0 1)。SLNB替代ALND者未发现明显近期术后并发症。结论 联合应用99Tcm SC显像及染料法检出SLN成功率较单独应用染料法高。SLNB替代ALND可提高患者术后生存质量。
Objective To explore the significance of sentinel lymph node (SLN) in breast carcinoma with different methods. Methods Three hundred and thirty two patients with breast carcinoma were examined with blue dye and the combination of 99 Tc m sulfur colloid (SC) scintigraphy and blue dye tracing, respectively, in order to find the best way for identifying the SLN. Twenty five patients with tumor less than 3 cm in diameter were treated with SLN biopsy (SLNB) instead of axillary lymph node dissection (ALND) to compare the advantage of two therapies. Results SLNs were successfully identified in 325 of 332(97.8%) patients. The accuracy of SLNB for predicting axillary lymph node status was 94.2%, with 14.0% false negative rate. The success rate, accuracy and false negative rate in blue dye group and combination group were 96.7%, 92.2%, 21.6%, and 100%, 97.5%, 4.8%, respectively. The false negative rate in combination group was significantly lower than in blue dye group ( χ 2=7.91, P <0.01). No operation complications were found in all the patients undergone SLNB only. Conclusions In this study, SLNB accurately predicted the axillary status in breast carcinoma with clinically declared negative nodes; the combination method was superior than the blue dye method in identifying SLN; the extent of axillary surgical dissection was decreased significantly in SLNB only group, and a better outcome was obtained so far.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2003年第3期136-138,T001,共4页
Chinese Journal of Nuclear Medicine
基金
山东省科技厅计划项目资助 (0 0 31 30 1 39)
