逆向腋淋巴显影技术在乳腺癌患者中的临床运用

发布时间：2018-06-20 16:01

本文选题：乳腺癌 + 上肢水肿　；参考：《南京医科大学学报(自然科学版)》2017年12期

【摘要】：目的 :探寻影响逆向腋淋巴显影(axillary reverse mapping,ARM)术中成功率的因素,了解ARM淋巴结的解剖分布、保留乳癌患者ARM淋巴结的风险。方法:对42例行腋窝淋巴结清扫的患者进行ARM,术中探寻蓝染淋巴结及淋巴管,常规清扫腋窝淋巴组织(包含ARM淋巴结),记录ARM操作成功数目和ARM淋巴结、淋巴管分布情况,将ARM成功率与患者年龄、身高、体重、上臂围和腋窝淋巴结转移情况进行相关性分析,统计ARM淋巴结病理结果,并与患者恶性肿瘤病理分期、免疫组化结果等进行相关性分析。结果:26例成功探及蓝染淋巴管和(或)淋巴结,成功率约61.9%,平均探及蓝染淋巴结1.54枚,ARM成功率与年龄、体重指数及上臂围有显著相关。送检的ARM淋巴结中,2例受肿瘤细胞侵袭,但ARM淋巴结被肿瘤侵袭的相关因素未能明确。结论:ARM临床操作成功率受患者个体自然因素影响,ARM淋巴结有肿瘤细胞侵袭的可能,选择ARM的适应证非常重要。
[Abstract]:Objective: to explore the factors influencing the success rate of antiaxillary reverse mapping (ARM) in order to understand the anatomical distribution of arm lymph nodes and the risk of preserving arm lymph nodes in patients with breast cancer. Methods: ARM was performed in 42 patients with axillary lymph node dissection. The blue stained lymph nodes and lymphatic vessels were explored during the operation. The armpit lymphoid tissues (including arm lymph nodes) were routinely dissected. The number of successful arm operations and the distribution of arm lymph nodes and lymphatic vessels were recorded. The relationship between arm success rate and age, height, weight, arm circumference and axillary lymph node metastasis was analyzed, and the pathological results of arm lymph nodes were analyzed. Results the successful rate of blue stained lymphatic vessels and / or lymph nodes was 61.9% in 26 cases. The average success rate of arm in blue stained lymph nodes was significantly correlated with age, body mass index (BMI) and upper arm circumference. Two of the arm lymph nodes were invaded by tumor cells, but the factors related to the invasion of arm lymph nodes were not clear. Conclusion the successful rate of clinical operation of arm may be affected by individual natural factors, and it is very important to select the indication of arm.
【作者单位】：南京医科大学第一附属医院乳腺外科;
【基金】：国家自然科学基金青年基金(81202077)
【分类号】：R737.9

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