三种前哨淋巴通道构建乳腺癌多种淋巴引流模式及指导SLNB个体化方案的研究

Sentinel lymphtatic channels (SLCs) are the key channels in lymphatic metastasis of breast cancer cells and flowing to the sentinel lymph nodes (SLNs) of the tracer in sentinel lymph node biopsy (SLNB). We found that three kinds of SLCs existed in breast cancer patients and six types of the lymphatic drainage pattern (LDP) builded by three kinds of SLCs in our protophase study. However, several problems are not clear. What is the relationship among three kinds of SLC? Whether are there new types of LDP in breast? Can various types of LDP improve the accuracy of SLNB? Based on the essential clue found in our protophase study, we presume that there may be connection relation among three types SLCs, and more types of LDP may be discovered, and individualized program of SLNB may improve the accuracy of SLNB. In this study, the more precise proof of the connection relation among three kinds of SLC and types of LDP builded by three kinds of SLCs, will explored by using the method of nuclide imaging, double tracer staining, D2-40 immunohistochemical staining, anatomy of the SLCs and SLNs. The impact of various types of LDP on the procedure of SLNB and the role of various types of LDP in the design of individualized program of SLNB, will be also probed. The study will offer new angle for the study on the types of LDP. It will not only enrich the research achievement but also provide new technique and theoretical basis for improving the accuracy of SLNB.

前哨淋巴通道（SLC）是乳腺癌细胞淋巴转移和前哨淋巴结活检（SLNB）技术中示踪剂流至前哨淋巴结的关键通道。我们前期研究发现乳腺中有三种SLC，及由它们构建出六种淋巴引流模式（LDP）。但三种SLC间关系？是否存在新型LDP？能否依据各种类型LDP提高SLNB的精确度？目前尚不清楚。根据我们前期研究发现的基本线索，我们推测三种SLC间可能通过毛细淋巴管构建出新型LDP；依据各种LDP能提高SLNB的精确度。本项目采用核素显像、双染料染色、D2-40染色、SLC解剖、临床随机对照试验等方法，分别从微观和宏观，探寻三种SLC之间存在交通关系的确切证据，探明三种SLC构建多种类型LDP的确切证据；探讨各种类型LDP对SLNB的影响，明确乳腺LDP在SLNB个体化方案实施中的指导作用。本项目为乳腺LDP的研究提供新的视角，不仅丰富和完善其研究成果，而且为提高SLNB的精确度提供新的技术和理论基础。

前哨淋巴通道(SLC)是乳腺癌细胞淋巴转移和前哨淋巴结活检(SLNB)技术中示踪剂流 至前哨淋巴结的关键通道。本项目研究中我们发现乳腺中有三种SLC，即SSLC、PSLC、DSLC三种SLC共构建出六种淋巴引流模式(LDP)，分别为SSLC、PSLC、SSLC+PSLC、SSLC+DSLC、SSLC+PSLC+DSLC、DSLC+DSLC。根据我们研究发现的基本线索，我们发现三种SLC间可能是通过毛细淋巴管构建出新型LDP;依据各种LDP能提高SLNB的精确度。此外，本研究首次发现超声造影在评估乳腺癌SLC及SLN方面具有很好的应用前景。本项目为乳腺LDP的研究提供新的视角，不仅丰富和完善其研究成果，而且为提高SLNB的精确度提供新的技术和理论基础。