目的

探讨前哨淋巴通道(SLCs)的行走方向、途径、数量及其与前哨淋巴结(SLN)之间的关系。

方法

对91 例Ⅰ～Ⅱ期乳腺癌患者行术前淋巴显像,其中成功显示SLCs 者79 例,测量并记录SLCs的外侧角即θe。

结果

93.67%( n =74)的病例有一条主要的SLC,6.33%( n =5)的病例有两条SLCs。SLCs 主要走行在乳腺的外上象限( n =78,占98.73%),其中5 例(6.33%)SLCs 的θe 角为0° ～30°,28 例(35.44%)SLCs 的θe 角为31° ～60°,45 例(56.96%)θe 角为61° ～90°,均终止于腋窝SLNs,未发现有内乳区SLNs。

结论

通过乳晕下注射⁹⁹Tc^m-SC 行术前淋巴显像,显示SLCs 主要起源于乳晕的外上边缘,穿越乳腺的外上象限,终止于腋窝SLNs。通过术前对SLCs 和SLN 行走路线和数量的认识有助于手术医生在术中正确定位SLN,提高SLNB 的检出率、减少假阴性率。

Objective

To explore the direction, route and number of SLCs (Sentinel Lymphatic Channels) and their relationship with SLNs by using subareolar injection of technetium 99m sulfur colloid (⁹⁹Tc^m-SC).

Methods

Lymphoscintigraphy was performed in 91 breast cancer cases of stages Ⅰ～Ⅱ, and SLCs were identified successfully in 79 cases, in which the exit angle (θ_e) was tested.

Results

One SLC was identified in 74 cases, holding 93.67% and two SLCs were identified in 5 cases, holding 6.33%. And 6.33% of SLCs exited the areola with θ_e =0° ～30°( n =5),35.44% exited the areola with θ_e = 31° ～60°( n =28),and 56.96% exited the areola with θ_e = 61° ～90°( n =45); 98.73% of SLCs traveled through the upper, outer quadrant ( n =78), and terminated at an axillary SLN. No false negative or false positive was demonstrated by pathological analysis of SLNs which were identified according to SLCs.

Conclusions

Most SLCs exit the areola, traveled through the upper, outer quadrant and terminate at axillary SLNs. By using subareolar injection of ⁹⁹ Tc^m-SC, SLCs and SLNs can be identified preoperatively and dissected carefully during operation. The detection rate of SLCs can be improved and the false negative rate of SLNB can be reduced.