目的

探讨乳腺癌腔镜腋窝淋巴结清扫术安全性。

方法

64例乳腺癌患者分为腔镜手术组和传统手术组，每组32例。应用荧光实时定量PCR技术分别检测乳腺癌患者术前和术后外周血CK-19 mRNA表达。

结果

64例乳腺癌患者外周血CK-19 mRNA阳性率32.81%，腔镜手术组和传统手术组的外周血CK-19 mRNA阳性率分别为31.25%和34.38%，两组手术可能造成的外周血潜伏肿瘤细胞（OTC）扩散几率分别为4.34%和8.70%，两组间的差异无统计学意义。术前化疗后乳腺癌患者外周血中仍然存在OTC，且随肿瘤分期的增高而增多。

结论

腔镜腋窝淋巴结清扫手术和传统手术对外周血潜伏肿瘤细胞影响的差异无统计学意义；腔镜腋窝淋巴结清扫手术与传统腋窝淋结清扫术相比不增加肿瘤扩散的风险。

Objective

To evaluate the safety of endoscopic axillay lymph node dissection（E-ALND）by liposuction.

Methods

Sixty-four cases of breast cancer were divided into an E-ALND group and a traditional ALND group，32 cases in each group.CK-19 mRNA copy numbers in peripheral blood were detected with SYBR Green I real time polymerase chain reaction before and after operation.

Results

The positive expression rate of CK-19 mRNA was 32.81%in peripheral blood in the 64 patients，and 31.25%and 34.38%in the E-ALND group and the ALND group，respectively.The likelihood of hemotogenous dissemination of tumor cells was 4.34%and 8.70%in the E-ALND group and the ALND group，respectively；OTC（occult tumor cell）in peripheral blood of patients who underwent preoperative chemotherapy could still be detected，and increased with the upgrading of breast cancer stage.

Conclusions

There is no difference in hemotogenous dissemination of tumor cells in breast cancer between E-ALND and traditional ALND.Compared with the ALND group，the likelihood of hemotogenous dissemination of tumor cells does not increase in the E-ALND group.