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目的评价前哨淋巴结活检(SLNB)对预测乳腺癌腋窝淋巴结(ALN)肿瘤转移的临床价值;分析影响前哨淋巴结(SLN)检出率的因素。方法选择T1-2N0M0乳腺癌患者80例。取1%亚甲蓝3～5ml分四部位注射在乳腺肿瘤表面或取活检部位周围皮下组织内。此后,行不同方式的乳腺癌根治术,将所有SLN、非SLN送病理检查。将腋窝淋巴结转移情况与SLN进行对比;分析SLN检出率及影响检出率的因素。结果80例患者中76例检到SLN,检出成功率95%(76/80),敏感度86.21%(25/29),准确性94.74%(72/76),假阴性率13.79%(4/29),特异性100%(51/51),总阳性预测值为100%(25/25),总阴性预测值92.73%(51/55)。SLN检出率与术前化疗有关(P<0.05),与年龄、肿瘤位置、病理类型、雌激素受体(ER)无关(P>0.05)。结论SLNB敏感度较高,基本能准确地判断乳腺癌腋窝淋巴结转移情况。亚甲蓝染色法检测乳腺癌SLN经济实用。
Objective To evaluate the clinical value of sentinel lymph node biopsy (SLNB) in predicting tumor metastasis of axillary lymph node (ALN) in breast cancer and analyze the factors affecting the detection rate of sentinel lymph node (SLN). Methods Eighty patients with T1-2N0M0 breast cancer were selected. Take 1% methylene blue 3 ~ 5ml four points injection in the breast tumor surface or take the biopsy site around the subcutaneous tissue. Since then, different ways of breast cancer radical surgery, all SLN, non-SLN sent pathology. Axillary lymph node metastasis was compared with SLN; SLN detection rate and the impact of the detection rate of the factors. Results 76 out of 80 patients were detected with SLN, the detection rate was 95% (76/80), the sensitivity was 86.21% (25/29), the accuracy was 94.74% (72/76) and the false negative rate was 13.79% (4) / 29), the specificity was 100% (51/51), the total positive predictive value was 100% (25/25), the total negative predictive value was 92.73% (51/55). The detection rate of SLN was correlated with preoperative chemotherapy (P <0.05), but not with age, tumor location, pathological type and estrogen receptor (ER) (P> 0.05). Conclusion The sensitivity of SLNB is high, which can accurately determine the axillary lymph node metastasis in breast cancer. Methylene blue staining of breast cancer SLN economical and practical.