摘要
新辅助化疗后前哨淋巴结活检的有效性及安全性在临床淋巴结阴性乳腺癌中已逐步得到认可。随着越来越多淋巴结阳性乳腺癌以新辅助化疗作为初始治疗,并得到较高的腋窝淋巴结缓解率,探索淋巴结阳性乳腺癌经新辅助化疗后前哨淋巴结活检替代腋窝淋巴结清扫的有效性及安全性具有重要意义,但既往研究提示有较高的前哨淋巴结活检假阴性率(7.5%~24.5%),限制了其在临床中的应用。研究也发现,对于cN1使用双示踪法检出≥3枚前哨淋巴结、分子分型为Her-2过表达型或三阴性乳腺癌及切除新辅助化疗前活检证实转移的淋巴结均可明显降低假阴性率,这对于进一步探索前哨淋巴结活检在新辅助化疗后的应用具有重要的临床意义。
The effectiveness and safety of sentinel lymph node biopsy after neoadjuvant chemotherapy has been gradually recognized in clinical lymph node negative breast cancer.With more and more lymph node positive breast cancer initially treated with neoadjuvant chemotherapy,the higher complete pathological response rate of axillary lymph nodes was obtained.It is of great significance to explore the effectiveness and safety of sentinel lymph node biopsy instead of axillary lymph node dissection after neoadjuvant chemotherapy for lymph node positive breast cancer.However,previous studies had found that the false negative rate of sentinel lymph node biopsy was high(7.5%~24.5%)and its clinical application was limited.At the same time,the study also found that for Her-2 overexpression type or triple-negative breast cancer,detection of≥3 sentinel lymph nodes with cN1 dual-tracer method and biopsy of resected lymph nodes before neoadjuvant chemotherapy may significantly reduce the false negative rate.It is of great clinical significance to further explore the application of sentinel lymph node biopsy after neoadjuvant chemotherapy.
作者
黄珍
邹德宏
何向明
HUANG Zhen;ZOU De-hong;HE Xiang-ming(Liuzhou Workers’Hospital,Liuzhou 545005,China;Institute of Cancer and Basic Medicine(ICBM),Chinese Academy of Sciences,Cancer Hospital of the University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Hangzhou 310022,China)
出处
《中国肿瘤》
CAS
CSCD
北大核心
2020年第3期211-215,共5页
China Cancer
基金
2016年浙江省肿瘤医院青年科研培育基金(QN201602).
关键词
乳腺癌
新辅助化疗
前哨淋巴结活检
腋窝淋巴结清扫
假阴性率
breast cancer
neoadjuvant chemotherapy
sentinel lymph node biopsy
axillary lymph node dissection
false negative rate
作者简介
通信作者:何向明,E-mail:merchant001@163.com
