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目的 :探讨检测乳腺癌HE阴性的前哨淋巴结微转移对SNB预测腋淋巴结状态准确性的价值。方法 :以细胞角蛋白 19作为组织特异性标志 ,采用免疫组化的方法 ,对 32例HE阴性的 6 8枚前哨淋巴结的微转移灶进行检测。结果 :5例病人的 9个前哨淋巴结有微转移灶 ,其中 1例假阴性的 2枚前哨淋巴结均发现微转移灶。前哨淋巴结微转移灶的检出率是 13.2 % (9/ 6 8)。从而可使SNB预测腋淋巴结状态的敏感性从 95 .8%(2 3/ 2 4)提高到 10 0 % (2 8/ 2 8) ;准确性从 98.2 % (5 4/ 5 5 )提高到 10 0 % (5 5 / 5 5 )。结论 :应用CK19单抗检测乳腺癌HE阴性的前哨淋巴结微转移可提高SNB预测腋淋巴结状态的准确性
Objective: To investigate the value of detecting micrometastasis of sentinel lymph node in HE-negative breast cancer by SNB in predicting axillary lymph node status. Methods: The cytokeratin 19 was used as a tissue-specific marker. Immunohistochemistry was used to detect the micrometastasis in 32 HE-negative sentinel lymph nodes. Results: Nine sentinel lymph nodes of 5 patients had micrometastases, and one of them had micrometastases in 2 sentinel lymph nodes. The detection rate of sentinel lymph node micrometastasis was 13.2% (9/68). The sensitivity of SNB to predict axillary lymph node status was thus improved from 95.8% (2 3/2 4) to 10 0% (2 8/2 8), and accuracy increased from 98.2% (5 4/5 5) to 10 0% (5 5/5 5). CONCLUSIONS: Detection of HE-negative SLNs in breast cancer using CK19 monoclonal antibody may improve the accuracy of SNB in predicting axillary lymph node status