导管原位癌患者前哨淋巴结定位的最新进展。
An update of sentinel lymph node mapping in patients with ductal carcinoma in situ.
作者信息
Wilkie Caren, White Laura, Dupont Elisabeth, Cantor Alan, Cox Charles E
机构信息
Department of Surgery, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, 12902 Magnolia Drive, Suite 3157, Tampa, FL 33612, USA.
出版信息
Am J Surg. 2005 Oct;190(4):563-6. doi: 10.1016/j.amjsurg.2005.06.011.
OBJECTIVE
The purpose of our study is to further clarify the incidence of ductal carcinoma in situ (DCIS) patients that are upstaged upon final pathology and/or have metastatic disease in the axilla.
METHODS
All patients were diagnosed with DCIS or DCIS with microinvasion (DCISm) on their diagnostic biopsy and received a sentinel lymph node (SLN) biopsy between 1994 and 2004. Six hundred seventy-five patients were divided into 613 patients with DCIS and 62 patients with DCISm.
RESULTS
Sixty-six of 675 (10%) were upstaged to invasive cancer. Fifty-five of 613 (9%) patients with DCIS were upstaged, whereas 11 of 62 (18%) patients with DCISm were upstaged. Forty-nine of 675 (7%) patients had +SLN. Twenty-two of 49 (45%) patients with +SLN had invasive carcinoma or DCISm on final histology.
CONCLUSIONS
After review of histology, grade, type of biopsy, and mammographic findings, the combined findings of high grade, mass by mammography, and microinvasion predict patients at higher risk for invasive carcinoma. Selective utilization of SLN biopsy in DCIS is recommended.
目的
我们研究的目的是进一步阐明在最终病理检查时分期上调和/或腋窝有转移性疾病的导管原位癌（DCIS）患者的发病率。
方法
所有患者在诊断性活检时被诊断为DCIS或伴有微浸润的DCIS（DCISm），并在1994年至2004年间接受了前哨淋巴结（SLN）活检。675例患者分为613例DCIS患者和62例DCISm患者。
结果
675例中有66例（10%）分期上调为浸润性癌。613例DCIS患者中有55例（9%）分期上调，而62例DCISm患者中有11例（18%）分期上调。675例中有49例（7%）患者SLN为阳性。49例SLN阳性患者中有22例（45%）在最终组织学检查时有浸润性癌或DCISm。
结论
在回顾组织学、分级、活检类型和乳腺X线摄影结果后，高级别、乳腺X线摄影显示为肿块以及微浸润的综合结果预示着患者发生浸润性癌的风险较高。建议在DCIS中选择性地应用SLN活检。
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