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[围绕乳腺癌前哨淋巴结活检的争议性问题]

[Controversial issues surrounding sentinel lymph node biopsy in breast cancer].

作者信息

Noguchi Masakuni

机构信息

Surgical Center, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa 920-8640, Japan.

出版信息

Gan To Kagaku Ryoho. 2004 Feb;31(2):163-7.

PMID:14997745
Abstract

UNLABELLED

This article discusses controversies regarding sentinel lymph node (SLN) biopsy and offers the following

CONCLUSION

  1. Combination of radioisotopes and blue dye, and of peritumoral and subdermal injections, may enhance the success rates of SLN identification. 2. Preoperative lymphoscintigraphy is the most useful for detecting an internal mammary SLN. However, the practicability of internal mammary SLN biopsy remains in the investigative stage. 3. Intraoperative diagnosis of SLN is necessary because patients with SLN metastases may be treated immediately with axillary lymph node dissection (ALND), but both frozen sections and imprint cytology have limitations for detecting micrometastases. 4. SLN micrometastases (0.2-2.0 mm) may be of prognostic importance and these can be histologically diagnosed on permanent sections of 200 microns intervals. 5. SLN biopsy may be indicated for patients with large or high-risk DCIS. 6. The accuracy of SLN biopsy after preoperative chemotherapy is still considered unproven.
摘要

未标注

本文讨论了关于前哨淋巴结（SLN）活检的争议，并给出以下结论：1. 放射性同位素与蓝色染料联合使用，以及瘤周和皮下注射，可能会提高SLN识别的成功率。2. 术前淋巴闪烁显像对于检测内乳SLN最为有用。然而，内乳SLN活检的实用性仍处于研究阶段。3. SLN的术中诊断是必要的，因为SLN转移的患者可能需要立即进行腋窝淋巴结清扫术（ALND），但冰冻切片和印片细胞学在检测微转移方面都有局限性。4. SLN微转移（0.2 - 2.0毫米）可能具有预后意义，并且可以在间隔200微米的永久切片上进行组织学诊断。5. 对于大的或高危的导管原位癌（DCIS）患者，可能需要进行SLN活检。6. 术前化疗后SLN活检的准确性仍未得到证实。

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1
[Controversial issues surrounding sentinel lymph node biopsy in breast cancer].[围绕乳腺癌前哨淋巴结活检的争议性问题]
Gan To Kagaku Ryoho. 2004 Feb;31(2):163-7.
2
Current controversies concerning sentinel lymph node biopsy for breast cancer.当前关于乳腺癌前哨淋巴结活检的争议。
Breast Cancer Res Treat. 2004 Apr;84(3):261-71. doi: 10.1023/B:BREA.0000019952.55284.f2.
3
Dye- and gamma probe-guided sentinel lymph node biopsy in breast cancer patients: using patent blue dye and technetium-99m-labeled human serum albumin.染料和γ探针引导下的乳腺癌患者前哨淋巴结活检：使用专利蓝染料和锝-99m标记的人血清白蛋白
Breast Cancer. 2000 Jan;7(1):87-94. doi: 10.1007/BF02967195.
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Preoperative lymphoscintigraphy and internal mammary sentinel lymph node biopsy do not enhance the accuracy of lymphatic mapping for breast cancer.术前淋巴闪烁造影和内乳前哨淋巴结活检并不能提高乳腺癌淋巴绘图的准确性。
Am Surg. 2004 Dec;70(12):1050-5; discussion 1055-6.
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Lymphoscintigraphic visualization of internal mammary nodes with subtumoral injection of radiocolloid in patients with breast cancer.乳腺癌患者肿瘤下注射放射性胶体后内乳淋巴结的淋巴闪烁显像
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The use of periareolar intradermal Tc-99m tin colloid and peritumoral intraparenchymal isosulfan blue dye injections for determination of the sentinel lymph node.使用乳晕周围皮内注射锝-99m硫胶体和瘤周实质内注射异硫蓝染料来确定前哨淋巴结。
Clin Nucl Med. 2006 Dec;31(12):795-800. doi: 10.1097/01.rlu.0000246855.80027.b7.
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Sentinel lymph node as a new marker for therapeutic planning in breast cancer patients.前哨淋巴结作为乳腺癌患者治疗规划的新标志物。
J Surg Oncol. 2004 Mar;85(3):102-11. doi: 10.1002/jso.20022.
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Sentinel lymph node biopsy and breast cancer.前哨淋巴结活检与乳腺癌
Br J Surg. 2002 Jan;89(1):21-34. doi: 10.1046/j.0007-1323.2001.01962.x.
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Retrospective analysis of sentinel node localization in multifocal, multicentric, palpable, or nonpalpable breast cancer.多灶性、多中心性、可触及或不可触及乳腺癌前哨淋巴结定位的回顾性分析。
J Nucl Med. 2003 Jan;44(1):7-10.
10
Utility of intraoperative frozen section examination of sentinel lymph nodes in ductal carcinoma in situ of the breast.术中前哨淋巴结冰冻切片检查在乳腺导管原位癌中的应用。
Clin Breast Cancer. 2013 Oct;13(5):350-8. doi: 10.1016/j.clbc.2013.02.013. Epub 2013 Jun 20.