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淋巴显像和蓝染法在乳腺癌前哨淋巴结定位中的应用

Application of Lymphoscintigraphy and Blue Dye Method in Sentinel Lymph Node Location of Breast Cancer

  • 摘要: 目的探讨淋巴显像和蓝染法在乳腺癌前哨淋巴结(sentinel lymph node,SLN)定位中的应用。方法对191例乳腺癌患者应用99mTc-右旋糖苷(99mTc-DX)淋巴显像及美蓝蓝染法进行SLN识别与定位,并行前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)。结果淋巴显像方法探测SLN的检出率为86.9%(166/191),蓝染法为83.8%(160/191),淋巴显像联合蓝染法为96.3%(184/191);联合法检出率比淋巴显像、蓝染法的检出率高(P<0.05);淋巴显像法和蓝染法的检出率的差异无统计学意义(P>0.05);术前淋巴显像是否成功检出SLN与患者年龄、病史长短、显像前是否活检过、原发肿瘤部位、临床分期、病理类型、免疫组织化学染色结果均无关(P>0.05)。结论淋巴显像和蓝染法均能较准确的识别与定位乳腺癌SLN,淋巴显像联合蓝染法可以提高SLN的检出率,可用于指导SLNB。

     

    Abstract: ObjectiveTo evaluate the clinical application of lymphoscintigraphy and blue dye method in sentinel lymph node(SLN) location of breast cancer. MethodsOne hundred and ninety-one breast cancer patients underwent 99mTc-DX lymphoscintigraphy and blue dye method to locate sentinel lymph node, and then underwent sentinel lymph node biopsy (SLNB). ResultsThe detectable rate of SLN for lymphoscintigraphy was 86.9% (166/191), the rate for blue dye method was 83.8% (160/191), and the rate for lymphoscintigraphy combined with blue dye method was 96.3% (184/191). The positive rate of combined detectable method was significantly higher than that of lymphoscintigraphy or blue dye method (P<0.05). There was no significant difference of detectable rate between lymphoscintigraphy and blue dye method. The detectable rate was unrelated to patient's age, medical history, biopsy, tumor location, clinical stage, pathology and immunohistochemical result(P>0.05). ConclusionLymphoscintigraphy or blue dye method or combined method could be used to locate SLN, furthermore the combined method was the best one to identify SLNB.

     

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