皮下注射超声造影剂与美蓝定位乳腺癌前哨淋巴结的比较  

Comparison of sentinel lymph nodes in breast cancer between subcutaneous injection of ultrasound contrast agent and methylene blue localization

作　　者：樊云清[1] 丁永宁[1] 黄选东[1] 

机构地区：[1]江苏省淮安市第二人民医院超声科,223002

出　　处：《临床超声医学杂志》2013年第11期797-799,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨经皮下注射超声造影剂检查乳腺癌前哨淋巴结的可行性。方法57例乳腺癌患者分为两组。A组：24例术前4—6h在乳腺肿块周边皮下四点分别注射超声造影剂，标记检出的前哨淋巴结，术中单独分离。B组：33例在全身麻醉后，用亚甲蓝2ml沿肿块周边皮下分四点注射，经根治性手术切口沿淋巴管的走行寻找蓝染的淋巴结，并单独分离。两组患者均将前哨淋巴结送病理检查，随后完成乳腺癌改良根治术。结果A组检出前哨淋巴结准确率为95．8％，1例假阴性。B组检出前哨淋巴结准确率为97．0％，1例假阴性。两组检出率、准确性、敏感性及假阴性比较，差异无统计学意义（P〉0．05）。结论皮下注射超声造影剂与美蓝定位乳腺癌前哨淋巴结在检出率、准确性及敏感性方面均显示出良好效果，而超声造影创伤小，更利于术前乳腺癌前哨淋巴结活检。Objective To investigate the feasibility of subcutaneous injection of ultrasound contrast agent to examine sentinel lymph node（SLN）in breast cancer. Methods Fifty-seven patients with early breast cancer were divided into two groups. In group A, the breast masses of 24 patients were injected subcutaneously with ultrasound contrast agent at four points around breast masses 4~6 h before surgery. The labeled SLN with a marker pen were separated respectively in the operation. In group B, the breast masses of 33 patients were also injected subcutaneously with 2 ml methylene blue at four points around breast masses after general anesthesia. Blue-stained lymph nodes were detected along the lymphatic vessels in radical operation and separated respectively, The SLN were diagnosed by pathological examination, and then the modified radical mastectomy of breast cancer was completed. Results The SLN detection rate was 95.8% in group A and one case was false negative. The SLN detection rate was 97.0% in group B and one case was false negative. There were no significant differences in evaluation indexes between the two groups （P 〉 0.05 ）. Conclusions Subcutaneous injection of ultrasound contrast agent and methylene blue positioning of SLN in breast cancer has good effect in detection rate, accuracy and sensitivity. Subcutaneous injection of ultrasound contrast agent is more conducive to preoperative SLN biopsy in breast cancer.

关 键 词：超声检查 造影剂 皮下注射 美蓝染色 乳腺癌 前哨淋巴结 

分 类 号：R322.25[医药卫生—人体解剖和组织胚胎学] R445.1[医药卫生—基础医学]