王延红, 伊凯, 李克剑. 乳腺癌前哨淋巴结术中分子诊断的临床价值[J]. 蚌埠医科大学学报, 2017, 42(8): 1051-1053. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.012
    引用本文: 王延红, 伊凯, 李克剑. 乳腺癌前哨淋巴结术中分子诊断的临床价值[J]. 蚌埠医科大学学报, 2017, 42(8): 1051-1053. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.012
    WANG Yan-hong, YI Kai, LI Ke-jian. Clinical value of the intraoperative molecular diagnosis of sentinel lymph nodes in breast cancer[J]. Journal of Bengbu Medical University, 2017, 42(8): 1051-1053. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.012
    Citation: WANG Yan-hong, YI Kai, LI Ke-jian. Clinical value of the intraoperative molecular diagnosis of sentinel lymph nodes in breast cancer[J]. Journal of Bengbu Medical University, 2017, 42(8): 1051-1053. DOI: 10.13898/j.cnki.issn.1000-2200.2017.08.012

    乳腺癌前哨淋巴结术中分子诊断的临床价值

    Clinical value of the intraoperative molecular diagnosis of sentinel lymph nodes in breast cancer

    • 摘要: 目的:探讨乳腺癌前哨淋巴结术中分子诊断的临床价值,为乳腺癌病人提供准确而方便的术中诊断方法。方法:选取乳腺癌手术病人73例,均在术中行前哨淋巴结活检。手术中将获得的前哨淋巴结进行切割获得组织块,对组织块分别进行乳腺癌前哨淋巴结术中分子诊断、快速冷冻病理检测和印片细胞学检测,并在术后进行逐层切片病理检测,以术后病理检测为诊断金标准。结果:乳腺癌前哨淋巴结术中分子诊断敏感为84.62%,快速冷冻病理检测为73.08%,印片细胞学检测为69.23%,乳腺癌前哨淋巴结术中分子诊断敏感性明显高于快速冷冻病理检测和印片细胞学检测(P<0.05)。行乳腺癌前哨淋巴结术中分子诊断检测70次,其中前10次操作用平均用时(53.28±3.93)min;第11~25次操作平均用时(42.19±3.44)min;第26~70次操作平均用时(31.73±2.57)min。随着操作次数的增加,操作时间逐渐缩短,呈现良好的学习曲线(P<0.01)。乳腺球蛋白以及细胞角蛋白19的循环阈值与转移灶大小表现出明显的负相关关系(P<0.05)。结论:乳腺癌前哨淋巴结术中分子诊断敏感性高于快速冷冻病理检测和印片细胞学检测,检测方法容易掌握,具有较高的临床应用价值。

       

      Abstract: Objective:To investigate the clinical value of the intraoperative molecular diagnosis of sentinel lymph node in breast cancer,and provide the accurate and convenient intraoperative diagnosis method for breast cancer.Methods:The sentinel lymph node biopsies in 73 patients during operation were examined.The molecular diagnosis,quick frozen pathological detection and printing slice cytology test in intraoperative sentinel lymph node tissue of breast cancer were detected.The pathology of the layered sentinel lymph node tissue block after surgery was finished,and the result of which was set as the diagnostic gold standard.Results:The diagnostic sensitivities of molecular diagnosis,quick frozen pathological detection and printing slice cytology in sentinel lymph nodes of breast cancer were 84.62%,73.08% and 69.23%,respectively,and the sensitivity of molecular diagnosis in sentinel lymph node of breast cancer was significantly higher than that of quick frozen pathological detection and printing slice cytology test(P<0.05).Among the 70 times of molecular diagnosis test in sentinel lymph node of breast cancer,the average operation time of the first 10 times,11 to 25 times and 26 to 70 times was(53.28±3.93)min,(42.19±3.44)min and (31.73±2.57)min,respectively.With the increasing of operating frequency and shortening of operation time,the good learning curve was found(P<0.01).The cycle thresholds of mammaglobin and cytokeratin 19 were significantly negatively correlated with the metastases size(P<0.05).Conclusions:The diagnostic sensitivity of molecular diagnosis in sentinel lymph node of breast cancer is higher than that of quick frozen pathological detection and printing slice cytology test.The molecular diagnostic method is easy to grasp,and has high clinical values.

       

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