前哨淋巴结活检用于乳腺癌分期的多中心验证研究。

Multicentre validation study of sentinel node biopsy for staging in breast cancer.

作者信息

Bergkvist L, Frisell J

机构信息

Department of Surgery and Uppsala University Centre for Clinical Research, Central Hospital, Västerås, Sweden.

出版信息

Br J Surg. 2005 Oct;92(10):1221-4. doi: 10.1002/bjs.5052.

DOI:10.1002/bjs.5052

PMID:15988791

Abstract

BACKGROUND

The aim of this study was to validate sentinel node biopsy for axillary staging after the initial learning phase, and to analyse factors associated with false-negative biopsies.

METHODS

Some 675 patients, who had standard sentinel node biopsy followed by level I and II axillary clearance in one of 20 hospitals in Sweden and were operated on by 36 different surgeons, were recruited prospectively.

RESULTS

The overall detection rate was 94.5 per cent. It varied between surgeons but was not influenced by the number of operations per surgeon. Moreover, it was lower among older patients. The overall false-negative rate was 7.7 per cent. This rate was not affected by patient age, tumour histological type or Elston grade, but was increased in patients with multifocal tumours. Some 21 per cent of patients with a multifocal tumour diagnosed on postoperative histopathological analysis had a false-negative biopsy compared with 5.6 per cent of those with unifocal tumours (P = 0.004).

CONCLUSION

Sentinel node biopsy was shown to be a reliable method for axillary staging of unifocal breast tumours.

摘要

背景

本研究的目的是在初始学习阶段后验证前哨淋巴结活检用于腋窝分期的效果，并分析与假阴性活检相关的因素。

方法

前瞻性招募了约675例患者，这些患者在瑞典20家医院中的一家接受了标准前哨淋巴结活检，随后进行了Ⅰ级和Ⅱ级腋窝清扫术，手术由36位不同的外科医生进行。

结果

总体检出率为94.5%。不同外科医生之间存在差异，但不受每位外科医生手术例数的影响。此外，老年患者中的检出率较低。总体假阴性率为7.7%。该比率不受患者年龄、肿瘤组织学类型或埃尔斯特恩分级的影响，但多灶性肿瘤患者的假阴性率有所增加。术后组织病理学分析诊断为多灶性肿瘤的患者中，约21%的患者前哨淋巴结活检为假阴性，而单灶性肿瘤患者的这一比例为5.6%（P = 0.004）。