论文部分内容阅读
目的 探讨应用γ探测仪探测乳腺癌前哨淋巴结活组织检查 (SLNB)的临床价值。方法 5 3例乳腺癌患者 ,在肿块或活组织检查腔周围的乳腺实质内注射99Tcm 硫胶体 ,应用γ探测仪术中定位切除放射性浓聚的前哨淋巴结 (SLN) ,再行腋窝淋巴结清扫 (ALND)。SLN与腋窝淋巴结(ALN)同时行HE和免疫组织化学 (IHC)检测 ,以及用逆转录多聚酶链反应 (RT PCR)检测CK19mRNA的表达 ,观察SLN的检出率和用SLN预测ALN转移的准确性 ,评价SLN阴性的早期乳腺癌患者用SLNB代替ALND的可行性。结果 SLN检出灵敏度为 91% (4 8/ 5 3例 ) ,共检出SLN 91枚 ,平均 1.9枚。SLN预测ALN转移准确性为 10 0 % ,阳性预测值为 0。结论 术中用γ探测仪进行乳腺癌SLNB是可行的 ,SLN可预测腋窝其余淋巴结的转移情况 ,并可作为早期乳癌患者用SLNB代替ALND的可靠指标。
Objective To investigate the clinical value of γ detector in the detection of sentinel lymph node biopsy (SLNB) in breast cancer. METHODS: Totally 99Tcm sulfur colloids were injected into the breast parenchyma around the tumor or biopsy cavity in 53 cases of breast cancer patients. Radioactively collected sentinel lymph nodes (SLNs) were removed by γ-ray detector. Axillary lymph node dissection (ALND ). SLN and axillary lymph nodes (ALN) were simultaneously detected by HE and immunohistochemistry (IHC), and the expression of CK19 mRNA was detected by reverse transcription polymerase chain reaction (RT PCR). The detection rate of SLN and the accuracy of predicting ALN metastasis by SLN , To evaluate the feasibility of using SLNB instead of ALND in SLN-negative patients with early-stage breast cancer. Results The detection sensitivity of SLN was 91% (48/53 cases). A total of 91 SLNs were detected with an average of 1.9. The accuracy of SLN predicting ALN metastasis was 100% and the positive predictive value was 0. Conclusions Intraoperative use of γ detector for breast cancer is feasible. SLN can predict the metastasis of the remaining axillary nodes and can be used as a reliable indicator of ALNB replacement by SLNB in patients with early stage breast cancer.