■前哨淋巴结活检(SLNB)的应用已从早期乳腺癌扩展到新辅助化疗(NAC)的局部晚期乳腺癌。对于腋窝淋巴结阴性的患者,在NAC之前或之后执行SLNB仍然存在争议。
■评估NAC后SLNB在初始诊断时腋窝淋巴结阴性的乳腺癌患者中的诊断可行性和可靠性。
■通过进行相关研究,计算NAC后SLNB的合并识别率(IR)和假阴性率(FNR),并通过示踪剂类型和平均活检前哨淋巴结数量进行亚组分析。
■PubMed,Embase,科克伦,WebofScience,和Scopus数据库从2002年1月1日至2022年3月1日进行了搜索研究。采用QUADAS-2工具和MINORS项目评价纳入研究的质量。采用I2和Q检验评价研究间的异质性。采用随机效应模型和固定效应模型计算合并IR,FNR,95%置信区间(CI)。评估了出版偏见,并进行敏感性分析。根据示踪剂的类型(单/双)和平均活检前哨淋巴结的数量进行亚组分析(2/>2)。
■本研究共纳入21项研究,涵盖1716例患者(IR=93%,95%CI=90-96;FNR=8%,95%CI=6-11)。
■NAC后的SLNB可以作为腋窝淋巴结阴性的乳腺癌患者的可行且可靠的方法。在我们的研究中,示踪剂对SLNB的IR和FNR没有显著影响,活检淋巴结数目>2导致SLNBFNR降低。
UNASSIGNED: The application of sentinel lymph node biopsy (SLNB) has expanded from early breast cancer to locally advanced breast cancer with neoadjuvant chemotherapy (NAC). For patients with negative axillary lymph nodes, performing SLNB before or after NAC remains controversial.
UNASSIGNED: To evaluate the diagnostic feasibility and reliability of SLNB after NAC in breast cancer patients with negative axillary nodes at initial diagnosis.
UNASSIGNED: To calculate pooled identification rate (IR) and false negative rate (FNR) of SLNB after NAC on breast cancer patients with initially negative axillary nodes by enrolling relevant studies and perform subgroup analysis by the type of tracer and the number of biopsied sentinel lymph nodes in average.
UNASSIGNED: The PubMed, Embase, Cochrane, Web of Science, and Scopus databases from January 1, 2002, to March 1, 2022, were searched for studies. The QUADAS-2 tool and MINORS item were employed to evaluate the quality of the included studies. I2 and Q tests were used to evaluate the heterogeneity among the studies. Random-effects model and fixed-effects model were employed to calculate the pooled IR, FNR, and 95% confidence interval (CI). Publication bias was evaluated, and sensitivity analysis was performed. Subgroup analysis was performed according to the type of tracer (single/double) and the number of biopsied sentinel lymph nodes in average (⩽2/>2).
UNASSIGNED: A total of 21 studies covering 1716 patients were enrolled in this study (IR = 93%, 95% CI = 90-96; FNR = 8%, 95% CI = 6-11).
UNASSIGNED: The SLNB after NAC can serve as a feasible and reliable approach in breast cancer patients with negative axillary lymph node. In our study, no significant impact of tracer was found on the IR and FNR of SLNB, and the number of biopsy nodes >2 leads to the decreased FNR of SLNB.