乳腺癌前哨淋巴结清扫术：清扫多少个淋巴结足够，哪种技术最佳？
Sentinel lymph node dissection for breast cancer: how many nodes are enough and which technique is optimal?
作者信息
Woznick Amy, Franco Marianne, Bendick Philip, Benitez Pamela R
机构信息
Department of General Surgery, William Beaumont Hospital, 3577 West 13 Mile Road, Suite #201, Royal Oak, MI 48073, USA.
出版信息
Am J Surg. 2006 Mar;191(3):330-3. doi: 10.1016/j.amjsurg.2005.10.031.
BACKGROUND
Controversy exists in sentinel lymph node (SLN) mapping in breast cancer regarding the appropriate number of nodes to remove and the best technique for identification of the SLNs.
METHODS
A retrospective chart review from January of 1999 to January of 2004 was performed for all patients undergoing a SLN biopsy examination who had at least 1 positive SLN.
RESULTS
We identified 167 patients. A mean of 4.4 SLNs were removed per patient. All of the positive SLNs were identified by node 6. Radiotracer used alone identified 19 positive nodes (11.4%) and blue dye used alone identified 14 positive nodes (8.4%).
CONCLUSIONS
Our data show that 100% of positive SLNs are found by 6 nodes removed, thereby supporting the concept that the SLN dissection may not be complete by removing only 1 or 2 nodes or only the hottest node. The use of blue dye or radiotracer alone can contribute to the overall false-negative rate.
背景
在乳腺癌前哨淋巴结（SLN）定位方面，对于切除淋巴结的合适数量以及识别前哨淋巴结的最佳技术存在争议。
方法
对1999年1月至2004年1月期间所有接受前哨淋巴结活检检查且至少有1个阳性前哨淋巴结的患者进行回顾性病历审查。
结果
我们确定了167例患者。每位患者平均切除4.4个前哨淋巴结。所有阳性前哨淋巴结均在第6个淋巴结时被识别出。单独使用放射性示踪剂识别出19个阳性淋巴结（11.4%），单独使用蓝色染料识别出14个阳性淋巴结（8.4%）。
结论
我们的数据表明，切除6个淋巴结可发现100%的阳性前哨淋巴结，从而支持了仅切除1个或2个淋巴结或仅切除最“热”的淋巴结可能无法完成前哨淋巴结清扫的观点。单独使用蓝色染料或放射性示踪剂会导致总体假阴性率升高。
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