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目的探讨乳腺癌前哨淋巴结(SLN)定位和SLN微转移检测的临床意义。方法对66例乳腺癌患者行术前Y探测仪SLN定位,用RTPCR法检测SLN中CK19mRNA的表达。同时与常规病检法比较其检测敏感性。并比较转移组、微转移组、无转移组患者的临床病理资料。结果SLN定位成功率为97%,RTPCR法与常规病检法转移的检出率相比较差异有统计学意义(P<0.05)。在常规病检阴性的38例淋巴结中,RTPCR法检出8例有微转移。同时乳腺癌转移组与微转移组患者在肿物大小与淋巴管浸润上有相似性,而同无转移组差异有统计学意义(P<0.05)。结论RTPCR法较常规病理检查更为敏感,通过SLN定位和RTPCR的联合使用,可明显提高乳腺癌SLN微转移的检出率。同时也证明RTPCR法是可靠的,SLN微转移有可能作为肿瘤预后的指标。
Objective To investigate the clinical significance of sentinel lymph node (SLN) localization and SLN micrometastasis detection in breast cancer. Methods Sixty-six patients with breast cancer underwent pre-operative Y detector SLN localization. The expression of CK19 mRNA in SLN was detected by RTPCR. At the same time compared with conventional disease detection sensitivity test. The clinical and pathological data of patients in metastasis group, micrometastasis group and non-metastasis group were compared. Results The success rate of SLN localization was 97%. There was significant difference between the RTPCR method and the conventional method (P <0.05). In 38 cases of lymph nodes that were negative for routine tests, micrometastases were detected in 8 cases by RTPCR. At the same time, there were similarities between tumor size and lymphatic invasion in patients with breast cancer metastasis and micrometastasis, but there was significant difference between them (P <0.05). Conclusion The RTPCR method is more sensitive than routine pathological examination. The combination of SLN localization and RTPCR can significantly improve the detection rate of SLN micrometastasis in breast cancer. Also proved RTPCR method is reliable, SLN micrometastases may be used as an indicator of tumor prognosis.