Nwariaku F E, Euhus D M, Beitsch P D, Clifford E, Erdman W, Mathews D, Albores-Saavedra J, Leitch M A, Peters G N
Department of Surgery, University of Texas Southwestern Medical Center and St. Paul Medical Center, Dallas 75235-9031, USA.
Am J Surg. 1998 Dec;176(6):529-31. doi: 10.1016/s0002-9610(98)00276-1.
Axillary metastases remain an important prognostic indicator in breast cancer. Axillary lymphadenectomy (ALND) carries significant morbidity and is unnecessary in most patients with early breast cancer; thus, sentinel lymph node (SLN) biopsy has been advocated for axillary staging. We studied the SLN identification rate and its accuracy in predicting axillary metastases.
One hundred nineteen women with breast carcinoma underwent SLN and ALND. Lymphoscintigraphy was performed using Technetium99 sulfur colloid supplemented by Isosulfan blue dye. Hematoxylin/eosin-stained lymph node sections were examined by light microscopy.
The SLN identification rate was 81%. One SLN was negative (1%) in a patient with axillary disease. SLN histology correctly predicted the absence of axillary disease in 98.6%. Sensitivity, specificity, and positive and negative predictive values were 96%, 100%, 100%, and 99%, respectively.
Sentinel lymph node biopsy accurately predicts total axillary status and is valuable in the surgical staging of breast cancer.
腋窝转移仍是乳腺癌重要的预后指标。腋窝淋巴结清扫术（ALND）具有显著的发病率，且对大多数早期乳腺癌患者来说并非必要；因此，前哨淋巴结（SLN）活检已被提倡用于腋窝分期。我们研究了SLN识别率及其预测腋窝转移的准确性。
119例乳腺癌女性患者接受了SLN活检和ALND。使用锝99硫胶体补充异硫蓝染料进行淋巴闪烁显像。苏木精/伊红染色的淋巴结切片通过光学显微镜检查。
SLN识别率为81%。一名腋窝有病变的患者中一个SLN为阴性（1%）。SLN组织学正确预测腋窝无病变的比例为98.6%。敏感性、特异性、阳性预测值和阴性预测值分别为96%、100%、100%和99%。
前哨淋巴结活检能准确预测腋窝整体状况，在乳腺癌手术分期中具有重要价值。
