Biopsija limfnoga čvora 'čuvara' kod raka dojke; iskustvo stečeno u Klinici za tumore, Zagreb, Hrvatska

Autor: Vrdoljak, Danko Velimir, Stanec, Mladen, Lesar, Miroslav, Juzbašić, Stjepan
Jazyk: angličtina
Rok vydání: 2003
Předmět:
Zdroj: Libri Oncologici : Croatian Journal of Oncology
Volume 31
Issue 1-3
ISSN: 2584-3826
0300-8142
Popis: The study was aimed at analyzing metastatic involvement in sentinel lymph node in patients with primary breast cancer. The study includes 51 female patients undergoing surgery for primary breast cancer at the University Hospital for Tumors, Zagreb, Croatia. Prior to the standard surgical procedure, sentinel lymph node biopsy was performed and patohistologically and immunohistochemically analyzed. Sentinel lymph node biopsy was done in 51 patients meeting the indication criteria for the procedure. In 39 (76.47%) biopsy samples immunohistochemical results were negative (no signs of metastases), in 11 (21.57%) the result was positive, and in 1 (1.96%) patient the sentinel lymph node was not located using the gamma probe following the preoperative lymphoscintigraphy. Recently, a new phase in conserving surgery for breast cancer has started. Considering the presence of the so-called skip metastases in 2% of the cases, the idea of conserving surgery for axillary lymph nodes occurred, and thus the sentinel node surgery has been developed. In simple terms, in case the sentinel lymph node is negative, other axillary lymph nodes should not be removed; if the node is positive, a classic axillary dissection, i.e. the removal of axillary lymph nodes should be done.
U radu je analizirana metastatska zahvaćenost limfnoga čvora „čuvara“ u bolesnica s primarnim rakom dojke. Analizirana je 51 bolesnica s primarnim rakom dojke operirana u Klinici za tumore, Zagreb, Hrvatska u razdoblju.Prije standardnog kirurškog zahvata, učinjena je biopsija čimfnog čvora „čuvara“, a potom su uzorci analizirani patohistološki i imunohistokemijski. Biopsija limfnog čvora „stražara“ je učinjena u 51 bolesnice koje su zadovoljavale indikaciju za navedeni postupak. U 39 (76,47%) uzoraka biopsije imunohistokemijska obrada dala negativan rezultat (nema znakova metastaza), u 11 (21,57%) uzoraka je nalaz pozitivan, a u jedne (1,96%) bolesnice limfni čvor „stražar'' nije lociran gama-kamerom nakon preoperacijske limfoscintigrafije U zadnje vrijeme teži se poštednim zahvatima u postupcima operacije raka dojke. Znajući da je postojanje tzv. „skip metastaza” negdje oko 2 %, pojavljuje se ideja o poštednoj operaciji aksilarnih limfnih čvorova. Tako je stvorena kirurgija „sentinel” limfnog čvora (limfnog čvora „stražara“). Pojednostavljeno, ako je „sentinel” limfni čvor negativan, ne bi trebalo uklanjati druge limfne čvorove u pazuhu, a ako je pozitivan, činila bi se i dalje klasična disekcija aksile s uklanjanjem aksilarnih limfnih čvorova.
Databáze: OpenAIRE
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