超声造影与亚甲蓝示踪检测兔VX2乳腺癌前哨淋巴结的比较研究  

Detection of Ultrasound Contrast and Methylene Blue Tracer on the Sentinel Lymph Node in Rabbit VX2 Breast Cancer

作　　者：丁炎[1] 贺雪梅[1] 丁雅明[1] 夏纪筑[1] 张骄[1] 于廷和[1] 白晋[1] 

机构地区：[1]重庆医科大学生物医学工程系重庆市生物医学工程学重点实验室重庆市超声医学工程重点实验室,重庆市400016

出　　处：《中国超声医学杂志》2010年第3期197-199,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.10774198)

摘　　要：目的通过与亚甲蓝(MB)示踪法比较,探讨超声造影检测乳腺癌前哨淋巴结(SLN)的前景。方法建立兔VX2乳腺癌模型24只,皮下注射SonoVue,超声造影显像SLN,观察其造影增强情况;再经皮下注射MB示踪;行腋窝淋巴结清扫术切除前哨淋巴结(sentinel lymph node,SLN)并行AE1/AE3免疫组化染色。结果 24只荷瘤兔超声造影检出回声均匀性增强的SLN 12个,回声不均匀性增强和部分充盈缺损的SLN 22个;MB示踪法检出SLN 32个;术中腋窝淋巴结清扫SLN 38个。以手术切除的SLN免疫组化结果为标准,超声造影的检出率(89.47%)、敏感性(95.24%)与MB示踪法检出率(84.21%)、敏感性(91.30%)比较无显著差异(P>0.05);但其特异性(84.62%)和准确性(91.18%)均明显高于MB示踪法特异性(26.67%)和准确性(65.79%)(P<0.05)。结论经皮下注射超声造影剂显像乳腺癌SLN与MB示踪法比较有一定优势,有望成为检测SLN的常用方法。Objective To explore the prospects of contrast-enhanced ultrasound and methylene blue （MB） detection of breast cancer sentinel lymph node （SLN） . Methods Twenty-four rabbit models of VX2 breast cancer were set up with subcutaneous injection of SonoVue to get contrast-enhanced ultrasound imaging of SLN. The situation of contrast-enhanced SLN was observed. Then subcutaneous injection of MB was performed to trace SLN. SLN was resected from axillary lymph nods, which underwent immuno histochemistry of AE1/AE3. Results Among the twentyfour rabbits, 12 SLN were with homogeneous echo-enhanced. 22 SLN enhanced non-uniformities were found by contrast-enhanced ultrasound. By MB tracer method 32 SLN were detected. 38 SLN were resected from axillary lymph nodes. To make surgical resection as the standard, the detection rate of contrast-enhanced ultrasound （89.47%） and the MB tracer detection rate （84.21%） showed no significant difference （P〉0.05） . Contrast-enhanced ultrasound sensitivity （95.24%） and the MB tracer method sensitivity （91.30%） showed no significant difference （P〉0.05）, but the specificity （84.62 %） and accuracy （91.18%） from contrast-enhanced ultrasound sensitivity were significantly higher than those from tracer MB method [specificity （26.67%） and accuracy （65.79%）] （P〈0.05） . Conclusions Contrast-enhanced ultrasound imaging in detecting SLN of breast cancer gets a higher detection rate, specificity, accuracy and sensitivity compared with the MB tracer method, which is expected to become the common method in detection of SLN.

关 键 词：超声造影 乳腺癌 前哨淋巴结 亚甲蓝示踪 AEl/AE3 

分 类 号：R737.9[医药卫生—肿瘤]