Objective To explore the clinical value of only using blue dye as tracer in the sentinel lymph node biopsy (SLNB) of breast cancer. Methods SLNB was performed with the guidance of the combination of blue dye and isotope in all patients enrolled. SLNB data of blue dye only, and the combination method was recorded respectively for analyses. Results Three hundred and eight patients were enrolled in this prospective study. Significant differences were found in the identification rate (IDR, 93.5% vs. 99.4%, P=0.000), the false negative rate (FNR, 14.8% vs. 3.3%, P=0.007), the accuracy rate (AR, 89.6% vs. 97.8%, P=0.006), and the negative predictive value (NPV, 74.0% vs. 93.3%, P=0.012) between the blue dye alone and the combination method. The IDR and the FNR of the two methods were not significantly associated with the patient age, tumor size and location, histopathological type, type of biopsy and breast surgery, or ER, PR, and HER-2 status (all Pgt;0.05). The FNR of blue dye alone was significantly associated with clinically suspicious turgescence of axillary lymph nodes (P=0.042) and decreased followed by the increased number of sentinel lymph nodes obtained (P=0.000). Conclusions Compared with the combination method, SLNB guided with blue dye alone had significantly poorer IDR, AR, and NPV, and higher FNR. It is recommended that the combination of dye and isotope should be adopted for the guidance of SLNB in clinical practice rather than the use of blue dye alone.
ObjectiveTo evaluate the quality of life after sentinel lymph node biopsy (SLNB) in patients with breast cancer. MethodsFrom January 2004 to December 2006, 591 patients with breast cancer who were suitable for SLNB were divided into SLNB group (n=339) and axillary lymph node dissection (ALND) group (n=252). All patients didn’t have the upper extremity joints disease, the vascular nerve disease, and the cervical spondylosis previously. Results①In patients with SLNB, the circumferences of upper arm in one, two, and three weeks after operation were similar to those before operation (P=0.232, P=0.318, and P=0.415, respectively). While, in patients with ALND, the circumferences of upper arm in one or two weeks after operation were significantly bigger than those before operation (P=0.011, P=0.041, respectively), and the circumference in three weeks after operation was similar to that before operation (P=0.290). ②In patients with SLNB, the outreach angles of shoulder joint in one and two weeks after operation were significantly smaller than those before operation (P=0.031, P=0.043, respectively), and the angle in three weeks after operation was similar to that before operation (P=0.196). However, in patients with ALND, the angles in one, two or three weeks after operation were significantly smaller than those before operation (all Plt;0.001). ③The retention time of drainage tube in patients with ALND who received breast conserving surgery or mastectomy was significantly longer than that in patients with SLNB who received mastectomy (all Plt;0.001). ④The infection rate and the sensory disjunction rate in patients with ALND were significantly higher than those in patients with SLNB (P=0.002, Plt;0.001, respectively). ConclusionsFor patients with lymph node negative breast cancer, SLNB could decrease postoperative complications, and improve the quality of life. It could also save money by reducing hospital stay.
ObjectiveTo explore the feasibility and clinical efficacy of laparoscopic sentinel lymph node biopsy combined with endoscopic submucosal dissection(ESD) for patients with early gastric cancer(EGC). MethodsThe clinical data of 26 cases who received ESD combined with laparoscopic sentinel lymph node biopsy for EGC between March 2009 to August 2013 in Affiliated Hospital of Jiangnan University were analyzed retrospectively. These patients first underwent laparoscopic sentinel lymph node(SLN) biopsy. If frozen sectioning examination suggested there was lymph node metastasis, laparoscopic D2 radical gastrectomy would be operated. However, the ESD would be operated if the frozen sectioning examination was negative. ResultsThe total numbers of SLN were 95, and mean numbers of SLN were 3.7±1.4(range from 1 to 6). Two patients with positive SLN underwent laparoscopic-assisted distal gastrectomy and 24 patients with negative SLN underwent ESD. The disease free survival(DFS) and local recurrence rate after ESD for EGC was 91.7%(22/24) and 4.2%(1/24), respectively. And the total DFS for all patients was 96.2% (25/26). ConclusionESD for EGC is a safe and feasible procedure, combined with laparoscopic sentinel lymph node biopsy conforms more to the concept of principle of radical operation.
ObjectiveTo summarize the research progress of sentinel lymph node biopsy (SLNB) in the surgery of thyroid carcinoma in recent years. MethodsLiteratures about the recent studies on categories of SLNB and the neck lymph node dissection conducted by SLNB in the surgery of thyroid carcinoma were reviewed following the results searched from PubMed and CNKI data base. ResultsSLNB has a high detection rate and it is of great significance to detect the occult metastatic lymph nodes and guide the neck lymph node dissection during operation. ConclusionThe SLNB, with its high accuracy rate on the detection of occult metastatic lymph nodes, guides neck lymph node dissection during operation in order that it can maximize the benefits of patients.