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目的探讨亚甲蓝染料定位法检测乳腺癌前哨淋巴结(SLN)的临床价值。方法对65例腋窝淋巴结临床检查阴性的乳腺癌患者在行乳腺癌根治性手术前用0.5%亚甲蓝4 mL注射定位,单独活检SLN;同时行常规腋窝淋巴结清扫术,根据注射部位,将入组患者分为乳晕注射组(34例)和肿块旁注射组(31例),其中对两组的检出结果进行比较。结果58例患者SLN成功检出,检出率为89.22%(58/65),假阴性率为8.33%(1/12)。乳晕周围注射组的检出率为85.29%(29/34),假阴性率为20.0%(1/5);肿块周围腺体内注射组检出率为93.55%(29/31),无假阴性病例。两组的检出率和假阴性率比较结果均无统计学差异(P>0.05);15例出现SLN和非SLN均蓝染,其中乳晕周围注射组11例,发生率为37.93%(11/34),肿块周围腺体内注射组4例,发生率为13.79%(4/31),两者比较差异有显著性(P<0.05)。结论亚甲蓝是一种安全、可靠的乳腺癌SLN示踪剂;肿块周围腺体内注射SLN定位较乳晕注射准确。
Objective To investigate the clinical value of methylene blue dye localization in detection of sentinel lymph node (SLN) in breast cancer. Methods 65 cases of breast cancer patients with negative axillary lymph node examination before breast cancer radical surgery with 0.5% methylene blue 4 mL injection location, biopsy SLN alone; at the same time conventional axillary lymph node dissection, according to the injection site, into the The patients were divided into areola injection group (34 cases) and tumor side injection group (31 cases). The detection results of the two groups were compared. Results Fifty-eight patients were detected with SLN successfully. The detection rate was 89.22% (58/65) and the false negative rate was 8.33% (1/12). The rate of false negative rate was 20.0% (1/5) in the injection group around the areola, and the positive rate was 93.55% (29/31) in the glandular injection group. No false Negative cases. There was no significant difference between the two groups in the detection rate and the false negative rate (P> 0.05). Among the 15 cases, SLN and non-SLN were blue staining, 11 cases were injected around the areola, the incidence rate was 37.93% 34). There were 4 cases in the gland injection group around the tumor, the incidence rate was 13.79% (4/31). There was significant difference between the two groups (P <0.05). Conclusions Methylene blue is a safe and reliable SLN tracer for breast cancer. Injection of SLN into the glands around the tumor is more accurate than injection into the areola.