Optimal Sampling Number of Sentinel Lymph Nodes in Invasive Breast Cancer: Results of 1,026 Sentinel Lymph Node Biopsies Done by Radioisotope
Optimal Sampling Number of Sentinel Lymph Nodes in Invasive Breast Cancer: Results of 1,026 Sentinel Lymph Node Biopsies Done by Radioisotope
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DOI：
10.4048/jbc.2011.14.s.s37
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发表时间：
2011-02-01
影响因子：
2.4
通讯作者：
Lee, Soo Jung
中科院分区：
文献类型：
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作者：
Choi, Jung Eun;Park, Shin Young;Lee, Soo Jung
目的：对于同位素作图，许多作者将前哨淋巴结（SLN）定义为含有同位素计数高于腋窝背景的淋巴结。然而，没有研究试图定义一个最佳的指南，并且精确检测转移性sln所需的sln数量仍然是一个有争议的话题。因此，我们着手确定sln的最佳采样数。方法：2005年1月至2008年12月，纳入1026例原发性浸润性乳腺癌患者。这些患者在岭南大学医院接受了使用放射性同位素的前哨淋巴结活检（SLNB）。在SLNB期间，测量每个SLN的体外同位素计数。同时，我们还研究了收获的sln的数量和转移情况。我们将sln定义为显示同位素计数>=腋窝背景的10倍的淋巴结。每个SLN被标记为Si（最高同位素计数）、S2（第二高同位素计数）或S3，依此类推。如果SLN转移阳性，则进行完全性腋窝淋巴结清扫。结果：患者平均年龄48.9岁（范围22 ~ 83岁）。平均切除sln数为2.8个（范围1 ~ 11个）。在纳入的1026例患者中，311例（30.3%）发生SLN转移：258例（82.9%）患者Si阳性（S1+）， 40例（12.3%）患者S2阳性（Si-、S2+）， 13例（3.9%）患者S3阳性（Si-、S2-、S3+）。定义为S4、S5等的sln无转移。在Si、S2和S3中检测到转移前的平均sln取样数分别为1.24（1-4）、2.45（2-4）和3.46（3-5）。结论：在使用放射性同位素进行SLNB时，为了准确地分期腋窝淋巴结，应该去除sln的第3个同位素计数顺序。S3检测转移所需的sln平均数量为4个。
Purpose: For isotope mapping, many authors have defined the sentinel lymph node (SLN) as the one containing isotope counts higher than the axillary background. However, no study has sought to define an optimal guideline, and the number of SLNs needed for precise detection of metastatic SLNs is still a subject of debate. Accordingly, we set out to determine the optimal sampling number of SLNs. Methods: Between January 2005 and December 2008, we enrolled 1,026 patients with primary invasive breast cancer. These patients had received sentinel lymph node biopsy (SLNB) using radioisotopes at Yeungnam University Hospital. During SLNB, ex vivo isotope counts were measured for each SLN. And, the number and metastatic status of harvested SLNs were investigated. We defined SLNs as lymph nodes that show an isotope count >= 10 times that of the axillary background. Each SLN was labeled as Si (highest isotope count), S2 (second highest), or S3 and so on, in descending isotope-count-order. If an SLN was positive for metastasis, comple-tion axillary lymph node dissection was performed. Results: The mean age of patients was 48.9 years (ranges, 22-83 years). The mean number of removed SLNs was 2.8 (ranges, 1-11). Of the 1,026 patients enrolled, 311 (30.3%) had SLN metastasis: Si was positive (S1+) in 258 patients (82.9%), S2 was positive (Si-, S2+) in 40 patients (12.3%), and S3 was positive (Si-, S2-, S3+) in 13 patients (3.9%). There was no metastasis in SLNs defined as S4, S5 and so on. The average number of sampling SLNs until detecting metastasis in Si, S2, and S3 was 1.24 (1-4), 2.45 (2-4), and 3.46 (3-5). Conclusion: During SLNB done using radioisotopes, for accurate axillary lymph node staging, up to the 3rd isotope-count-order of SLNs should be removed. The average number of SLNs needed for detecting metastasis in S3 is four.