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目的探讨乳腺癌前哨淋巴结活检术(SLNB)代替腋窝淋巴结清扫术(ALND)的可行性。方法对75例SLNB手术、病理诊断和随访结果进行分析。结果 75例患者行SLNB,67例(89.33%)成功。其中快速病理检查报告18例阳性,49例阴性;49例SLN阴性中术后HE染色病理证实2例(4.10%)有癌转移,再行ALND;平均随访45个月,仅1例前哨活检阴性患者术后15个月证实前哨位置淋巴结有癌转移。另46例至今未见复发。结论单一亚甲蓝示踪法SLNB准确性较高。对器材无特殊要求,学习曲线短。对于SLNB阴性患者,可不需行ALND。
Objective To investigate the feasibility of using sentinel lymph node biopsy (SLNB) instead of axillary lymph node dissection (ALND) in breast cancer. Methods 75 cases of SLNB surgery, pathological diagnosis and follow-up results were analyzed. Results 75 patients underwent SLNB, 67 cases (89.33%) were successful. Among them, 18 cases were positive by pathological examination and 49 cases were negative by HE staining; 2 cases (4.10%) had SLN negative pathological findings, and ALND was followed up with a mean follow-up of 45 months. Only 1 case had negative sentinel biopsy Fifteen months after operation, the patient had metastatic lymph nodes at the outpost site. The other 46 cases have not seen recurrence so far. Conclusion Single methylene blue tracer method SLNB accuracy is high. No special equipment requirements, learning curve is short. For SLNB-negative patients, ALND may not be required.