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乳腺癌前哨淋巴结活检

Sentinel lymph node biopsy in breast cancer.

作者信息

Alsaif Abdulaziz A

机构信息

Department of Surgery, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.

出版信息

Saudi Med J. 2015 Sep;36(9):1053-60. doi: 10.15537/smj.2015.9.12228.

DOI:10.15537/smj.2015.9.12228
PMID:26318461
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4613628/
Abstract

OBJECTIVES

To report our experience in sentinel lymph node biopsy (SLNB) in early breast cancer.

METHODS

This is a retrospective study conducted at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between January 2005 and December 2014. There were 120 patients who underwent SLNB with frozen section examination. Data collected included the characteristics of patients, index tumor, and sentinel node (SN), SLNB results, axillary recurrence rate and SLNB morbidity.

RESULTS

There were 120 patients who had 123 cancers. Sentinel node was identified in 117 patients having 120 tumors (97.6% success rate). No SN was found intraoperatively in 3 patients. Frozen section results showed that 95 patients were SN negative, those patients had no immediate axillary lymph node dissection (ALND), whereas 25 patients were SN positive and subsequently had immediate ALND. Upon further examination of the 95 negative SN's by hematoxylin and  eosin (H and E) and immunohistochemical staining for doubtful H and E cases, 10 turned out to have micrometastases (6 had delayed ALND and 4 had no further axillary surgery). Median follow up of patients was 35.5 months and the mean was 38.8 months. There was one axillary recurrence observed in the SN negative group. The morbidity of SLNB was minimal.

CONCLUSION

The obtainable results from our local experience in SLNB in breast cancer, concur with that seen in published similar literature in particular the axillary failure rate. Sentinel lymph node biopsy resulted in minimal morbidity.

摘要

目的

报告我们在早期乳腺癌前哨淋巴结活检(SLNB)方面的经验。

方法

这是一项在沙特阿拉伯王国利雅得市哈立德国王大学医院于2005年1月至2014年12月期间进行的回顾性研究。有120例患者接受了前哨淋巴结活检及冰冻切片检查。收集的数据包括患者特征、原发肿瘤及前哨淋巴结(SN)情况、前哨淋巴结活检结果、腋窝复发率和前哨淋巴结活检的并发症。

结果

120例患者共患有123处癌症。117例患者(120处肿瘤)成功识别出前哨淋巴结(成功率97.6%)。3例患者术中未发现前哨淋巴结。冰冻切片结果显示,95例患者前哨淋巴结阴性,这些患者未立即行腋窝淋巴结清扫术(ALND),而25例患者前哨淋巴结阳性,随后立即行腋窝淋巴结清扫术。对95例前哨淋巴结阴性病例进一步进行苏木精和伊红(H&E)染色以及对可疑H&E病例进行免疫组化染色检查后,发现10例有微转移(6例延迟行腋窝淋巴结清扫术,4例未进一步行腋窝手术)。患者的中位随访时间为35.5个月,平均随访时间为38.8个月。前哨淋巴结阴性组观察到1例腋窝复发。前哨淋巴结活检的并发症极少。

结论

我们在乳腺癌前哨淋巴结活检方面的本地经验所获得的结果,与已发表的类似文献中的结果一致,尤其是腋窝失败率。前哨淋巴结活检导致的并发症极少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edea/4613628/ad963447b8bc/SaudiMedJ-36-1053-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edea/4613628/ad963447b8bc/SaudiMedJ-36-1053-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edea/4613628/ad963447b8bc/SaudiMedJ-36-1053-g001.jpg

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Identification of the sentinel lymph node in the SNAC-1 trial.SNAC-1试验中前哨淋巴结的识别
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