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目的评价年轻乳腺癌患者采用前哨淋巴结活检术(SLNB)的临床价值。方法选取2011年1月-2015年1月收治的年龄≤40岁早期乳腺癌60例行SLNB,根据术中前哨淋巴结(SLN)快速冰冻病理切片检查的结果,对于SLN阳性者(设定为对照组)进行规范的腋窝淋巴结清扫(ALND),对于SLN阴性者(设定为实验组)不进行进一步ALND。结果实验组患者手术时间、住院时间、腋窝引流时间分别为均少于对照组,差异有统计学意义(P<0.05)。SLN活检成功率为98%;其中,SLN阳性17例,SLN阴性42例,假阴性1例,假阴性率为1.67%。术后对患者进行15~60个月的临床随访,平均随访(31.2±2.5)个月。实验组术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。两组患者术后生存率均为100%,无瘤生存率均为100%。结论 SLNB为年轻早期乳腺癌保腋手术方式的选择提供了重要的临床参考依据,SLNB是早期乳腺癌一种很好的诊疗手段,可有效减轻手术创伤和术后并发症。
Objective To evaluate the clinical value of sentinel lymph node biopsy (SLNB) in young breast cancer patients. Methods From January 2011 to January 2015, 60 SLN patients with early stage breast cancer ≤ 40 years old were selected. According to the results of rapid frozen biopsy in sentinel lymph node (SLN) surgery, SLN positive patients Group) for axillary lymph node dissection (ALND) and no further ALND for SLN-negative individuals (set as experimental group). Results The operation time, hospitalization time and axillary drainage time in the experimental group were less than those in the control group respectively, with significant difference (P <0.05). SLN biopsy success rate was 98%; Among them, SLN positive in 17 cases, SLN negative in 42 cases, false negative in 1 case, false negative rate was 1.67%. The patients were followed up for 15 to 60 months, with a mean follow-up of (31.2 ± 2.5) months. The incidence of postoperative complications in the experimental group was significantly lower than that in the control group (P <0.05). The postoperative survival rates of both groups were 100%, and the tumor-free survival rate was 100%. Conclusion SLNB provides an important clinical reference for the selection of preserving axillary approach for young patients with early breast cancer. SLNB is a good treatment for early stage breast cancer and can effectively reduce the surgical trauma and postoperative complications.