Su Fengxi, Ba Mingchen, Zhou Xiaodong, Wu Xianrong, Li Yan, Chen Jisheng, Li Jun
Departonent of General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Zhonghua Zhong Liu Za Zhi. 2002 May;24(3):297-9.
To investigate the cause of sentinel lymph node biopsy failure and false negative result in vital blue injection for breast cancer.
Eight-four female breast cancer patients were injected with vital blue to find the sentinel lymph nodes during operation. All patients were treated by the traditional radical or modified radical mastectomy with axillary dissection after sentinel node biopsy. All sentinel nodes, axillary lymph nodes and dissected specimens were submitted separately to pathological examination.
Sentinel node was not identified at the time of operation in 11 patients, giving a failure rate of 13.1%. In 73 patients in whom sentinel nodes were identified, 32 (43.8%) revealed cancer invasion. Postoperative axillary node pathology showed cancer metastasis in all of them. Two patients who showed uninvaded sentinel nodes were demonstrated to have axillary node metastasis. These were the two false negative patients. Therefore, the prediction of axillary metastasis by the sentinel node biopsy showed a sensitivity of 90.4%, a specificity of 100% and a false negative rate of 2.7%.
Failure in identifying the sentinel nodes in vital blue injection is related to the degree of mastering the technique and the method of injection. The cause of false negative result is due to an extensive primary tumor and the variation in the position of the sentinel lymph nodes.
探讨乳腺癌术中使用亚甲蓝注射法进行前哨淋巴结活检失败及假阴性结果的原因。
84例女性乳腺癌患者术中注射亚甲蓝以寻找前哨淋巴结。所有患者在前哨淋巴结活检后均行传统根治性或改良根治性乳房切除术加腋窝淋巴结清扫术。所有前哨淋巴结、腋窝淋巴结及切除标本分别送病理检查。
11例患者术中未找到前哨淋巴结，失败率为13.1%。在73例找到前哨淋巴结的患者中，32例（43.8%）有癌侵犯。术后腋窝淋巴结病理检查显示所有患者均有癌转移。2例前哨淋巴结未受侵犯的患者被证实有腋窝淋巴结转移。这2例为假阴性患者。因此，前哨淋巴结活检对腋窝转移的预测敏感性为90.4%，特异性为100%，假阴性率为2.7%。
亚甲蓝注射法前哨淋巴结识别失败与技术掌握程度及注射方法有关。假阴性结果的原因是原发肿瘤范围广及前哨淋巴结位置变异。
