靶向腋窝淋巴结切除在新辅助化疗后腋窝淋巴结评估中的应用

doi:10.3969/j.issn.2095-9400.2021.06.008

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Abstract Objective: To explore the application of targeted axillary lymph node resection in the assessment of residual axillary lymph node metastasis in breast cancer patients after neoadjuvant chemotherapy. Methods: Totally 57 patients who were admitted to the Breast Disease Diagnosis and Treatment Center of Lishui Central Hospital and underwent neoadjuvant chemotherapy from June 2015 to May 2020 were prospectively errolled in this study. In 31 patients undergoing neoadjuvant chemotherapy, the marker clip was implanted into the metastatic axillary lymph node, confirmed by fine needle aspiration under ultrasound guidance. After chemotherapy, the labeled lymph node was punctured and stained under ultrasound guidance and then sentinel lymph node biopsy was performed at the same time as the marker removal of axillary lymph nodes (TAD), and then axillary lymph node was dissected (for TAD group). The remaining 26 cases received neoadjuvant chemotherapy alone. After the
chemotherapy was completed, sentinel lymph node biopsy was performed and then axillary lymph node was dissected (for the control group). Statistical analysis was made of the lymph node detection rate, accuracy, sensitivity and false negative rate of targeted axillary lymph node resection and sentinel lymph node biopsy. Results: Among 57 patients, at least one sentinel lymph node was detected in 53 cases. The detection rate of SLN was 92.98%. Among them, 31 cases were in the TAD group and 26 cases were in the control group. The detection rate of lymph nodes in the TAD group was 100.00% (31/31), with the average number of lymph nodes being 3.39 per case, the sensitivity 94.44% (17/18), the false negative rate 5.56% (1/18), and the accuracy rate 96.77%(30/31). The detection rate of lymph nodes in the control group was 84.62% (22/26), with the average number of lymph nodes detected being 3.38 per case, the sensitivity 62.50% (10/16), the false negative rate 37.50% (6/16), and the accuracy rate 72.73% (16/22). The detection rate, sensitivity and accuracy of lymph nodes in the TAD group were significantly higher than those of the control group, which showed statistical differences (P<0.05), and the false negative rate of the TAD group was significantly lower than that of the control group, with statistical differences (P<0.05). Conclusion: Targeted axillary lymph node dissection for breast cancer patients after neoadjuvant chemotherapy can actually reflect the axillary lymph node metastasis, compared with sentinel lymph node biopsy alone.

Key words： breast cancer marker clip targeted axillary lymph node dissection sentinel lymph node biopsy neoadjuvant chemotherapy

Received: 31 January 2021

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	LIU Pengpeng
	ZHOU Yi
	CAI Shibin
	YU Kaijie
	FENG Yaqin
	WU Aifen
	CHEN Shuzheng.

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2021.06.008 OR https://xb.wmu.edu.cn/EN/Y2021/V51/I6/473

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