目的

探讨乳腺癌腋窝微小淋巴结对乳腺癌分期的影响。

方法

127 例乳腺癌不同根治性手术清除的腋窝组织经专人按常规方法寻找淋巴结后,把腋窝脂肪组织切1 cm 厚浸泡于溶脂液(Carnoy's solution)6 ～12 h,取出腋窝脂肪组织置于玻璃板上寻找微小淋巴结,检出的淋巴结行常规病理检查。

结果

依靠常规方法检出淋巴结2 483 枚(平均每例19.55 ±7.95 枚);腋窝组织经溶脂液浸泡后检出1 ～6 mm 的淋巴结878 枚(平均每例6.9 ±5.31 枚),其中3 mm 以下的淋巴结781 枚。使平均腋窝淋巴结检出数量增加到26.47 ±9.69 枚。7 例患者的pN 改变,其中4 例pN0 升为pN1,2 例pN1 升为pN2,1 例pN2 升为pN3。

结论

该溶脂法能简捷地检出腋窝微小淋巴结,有助于乳腺癌的精确分期。

Objective

To evaluate the effect of tiny axillary lymph nodes in breast cancer staging.

Methods

Axillary specimens from 127 breast cancer patients were included. After excising the lymph nodes by palpation and visualization, the remaining axillary tissue was immersed into Carnoy's solution for 6-12 hours. Then the left axillary tissue was placed in the Pyrex tray and transilluminated from the below. The tiny lymph nodes were easily recognized as white chalky nodules standing out of the background with semitransparent fat. The lymph nodes were identified by pathologic examined.

Results

2 483 lymph nodes were found by the traditional methods and 878 more lymph nodes were found by immersed into Carnoy's solution. Among them 781 lymph nodes were smaller than 3 mm. The average number of lymph nodes founded by the new way was 26.47 ±9.69 compared to 19.55 ±7.95 by the routine method. Four cases considered previously to be pN0 became pN1, two cases previously graded as pN1 became pN2,and another case was upstaged from pN2 to pN3.

Conclusions

The new method is an easy and effective way for detecting tiny lymph nodes in axillary,and it helps to accurate staging and possibility change the method of therapy.