利用超声造影示踪兔VX2乳腺癌前哨淋巴结的实验研究  

A study of using ultrasound contrast tracer on the sentinel lymph node in rabbit VX2 breast cancer

作　　者：丁炎[1,2,3] 夏纪筑[1,2,3] 丁雅明[1,2,3] 贺雪梅[1,2,3] 白晋[1,2,3] 

机构地区：[1]重庆医科大学生物医学工程系 [2]重庆医科大学生物医学工程学重点实验室 [3]重庆市超声医学工程重点实验室-省部共建国家重点实验室培育基地,重庆400016

出　　处：《重庆医科大学学报》2011年第3期273-276,共4页Journal of Chongqing Medical University

基　　金：国家自然科学基金项目资助(编号:10774198)

摘　　要：目的:通过与亚甲蓝(Methylene blue,MB)示踪法比较,探讨超声造影检测乳腺癌前哨淋巴结(Sentinel lymph node,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SLN并行AE1/AE3免疫组化染色。结果:24只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。以手术切除为标准,超声造影的检出率(89.47%)与MB示踪法检出率(84.21%)比较无显著差异(P>0.05);以免疫组化结果为标准,超声造影的敏感性(95.24%)与MB示踪法敏感性(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有较高的检出率、特异性、准确性和敏感性,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 was set up with,subcutaneous injection of SonoVue,to get contrast-enhanced ultrasound imaging of SLN.The situation of contrast-enhanced SLN was observed.Thenubcutaneous 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 twenty-four rabbits,12 SLN homogeneous echo-enhanced.22 SLN enhanced non-uniformity 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（P0.05）.To make the results of immunohistochemistry criteria as the standard,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%） were significantly higher from contrast-enhanced ultrasound sensitivity than those from tracer MB method-specificity（26.67%） and accuracy（65.79%）（P0.05）.Conclusion：Contrast-enhanced ultrasound imaging indetecting 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 AE1/AE3 

分 类 号：R445.1[医药卫生—影像医学与核医学]