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乳腺癌前哨淋巴结活检(sentinel lymph node biopsy,SLNB)是乳腺外科领域里程碑式的进步,成为临床早期乳腺癌标准治疗的重要组成部分。然而,假阴性率(false-negative rate,FNR)的客观存在一定程度上阻碍了SLNB在临床工作中的推广应用。国内外研究资料显示,SLNB FNR约为10%,而美国乳腺外科医师协会建议,经SLNB证实的阴性前哨淋巴结(sentinel lymph node,SLN)可免于接受腋窝淋巴结清除术的纳入标准是FNR应维持在5%以下。本文从临床因素(肿瘤体积、多灶性癌、新辅助化疗及跳跃转移)、示踪技术因素及病理学因素等方面,探讨FNR产生的原因、影响因素及其对策,以期在降低FNR方面提供一定的参考依据。
Sentinel lymph node biopsy (SLNB) is a landmark progress in breast surgery and has become an important part of the standard treatment for early-stage breast cancer. However, the objective existence of false-negative rate (FNR) has hindered the popularization and application of SLNB in clinical work to some extent. According to domestic and international research data, the SLNB FNR is about 10%, and the American Breast Surgeon Association recommends that the SLNB-approved sentinel lymph node (SLN) be exempt from axillary lymph node dissection. The inclusion criteria is that the FNR should be maintained. Below 5%. This article explores the causes, influencing factors and countermeasures of FNR from clinical factors (tumor volume, multifocal cancer, neoadjuvant chemotherapy and skip metastasis), tracer technique factors, and pathological factors, in order to provide a reduction in FNR A certain reference.