摘要目的 探讨前哨淋巴结活检(SLNB)联合术前超声对早期乳腺癌患者腋窝淋巴结转移的预测价值.方法 2014年6月至2018年10月期间连续入住兰州大学第二医院普外科340例早期乳腺癌患者分为三组:术前超声组113例、SLNB组75例、SLNB联合术前超声组152例.以腋窝淋巴结清扫结果为金标准,对SLNB、超声及SLNB联合超声诊断腋窝淋巴结转移进行比较.结果 SLNB组、术前超声组、SLNB联合超声组可疑腋窝淋巴结活检灵敏度分别为90.1％、85.7％、96.4％,特异度为84.0％、76.3％、100％,准确性分别为91.6％、83.0％、97.4％,假阴性率分别为8.6％、14.3％、3.6％.结论 术前超声诊断腋窝淋巴结状态联合前哨淋巴结活检可提高早期乳腺癌腋窝淋巴结转移的诊断率,有助于提高早期乳腺癌腋窝淋巴结评估的准确性.

abstractsObjective To investigate the prediction of axillary lymph node metastasis in patients with early breast cancer by sentinel lymph node biopsy (SLNB) combined with preoperative ultrasound.Methods From Jun 2014 to Oct 2018,340 patients with early breast cancer were enrolled in the 5th Department of General Surgery of Second Hospital of Lanzhou University.113 cases were grouped into ultrasound examing,75 patients in the SLNB,and 152 patients in the SLNB combined with preoperative ultrasound.Using the results of axillary lymph node dissection as gold standard,the 3 groups were compared.Results The sensitivity of SLNB,ultrasound and SLNB combined with ultrasound for suspicious axillary lymph node biopsy were 90.1％,85.7％,and 96.4％,respectively.The specificity was 84.0％,76.3％,and 100％,and the accuracy was 91.6％,83.0％,and 97.4％,respectively.The false negative rates were 8.6％,14.3％,and 3.6％,respectively.Conclusion Preoperative ultrasound diagnosis of axillary lymph node status combined with sentinel lymph node biopsy can significantly improve the diagnosis rate of axillary lymph node metastasis in early breast cancer.