吲哚菁绿联合美蓝在乳腺癌前哨淋巴结活检术中的应用  

Combination of ICG and methylene blue for mapping sentinel lymph nodes in early breast cancer patients

作　　者：曹迎明[1] 王殊[1] 郭嘉嘉[1] 杨德起[1] 佟富中[1] 周波[1] 刘鹏[1] 刘宏军[1] 程琳[1] 

机构地区：[1]北京大学人民医院乳腺中心,100044

出　　处：《中华普通外科杂志》2014年第2期119-122,共4页Chinese Journal of General Surgery

基　　金：首都医学发展科研基金资助项目

摘　　要：目的 探讨吲哚菁绿联合美蓝作为淋巴示踪剂在乳腺癌前哨淋巴结活检手术中的应用价值.方法 214例临床腋淋巴结阴性的早期乳腺癌患者随机分为两组,分别接受吲哚菁绿联合美蓝或者单用美蓝作为淋巴示踪剂.两组患者均进行常规前哨淋巴结活检手术.手术切除的前哨淋巴结送冰冻检查及常规石蜡和免疫组织化学病理检查.结果 吲哚菁绿皮肤淋巴管显影103例,显影率为96.3％,淋巴结荧光显影102例,显影率为95.3％.联合组检出率98.1％ （105/107）,美蓝组检出率93.4％ （100/107）.联合组共检出前哨淋巴结325枚,平均3.1枚；美蓝组检出淋巴结总数242枚,平均2.4枚（t=-3.3,P=0.001）.联合组检出腋窝淋巴结阳性患者19例,共检出转移淋巴结29枚,美蓝组检出腋窝淋巴结阳性患者17例,转移淋巴结21枚.结论 自发荧光物质吲哚菁绿联合美蓝作为淋巴示踪剂具有良好的可视性,检出前哨淋巴结数量和腋淋巴结阳性患者多于单用美蓝方法.Objective To evaluate intraoperative tracing of sentinel lymph node （SLN） by fluorescence imaging combined with methylene blue.Methods 214 early breast cancer patients eligible for sentinel lymph node biopsy were randomly assigned to combination group receiving indocyanine green （ICG） and methylene blue （MB） as the lymphatic mapping tracers and MB alone group.Intraoperative frozen section was performed,followed by conventional histopathology.Results In the combination group,subcutaneous lymphatic channels were successfully visualized in 103 patients and the detection rate was 96.3%.The fluorescence SLNs were successfully detected in 102 patients and the detection rate was 95.3%.In the combination group,sentinel lymph nodes were successfully identified in 105 patients,the SLNs detection rate was 98.1%.While in the dye alone group,the SLNs were found in 100 patients and the detection rate was 93.4%.The average number of detected SLNs was 3.1 （325/105） in combination group versus 2.4 （242/100） in dye alone group（t =-3.3,P =0.001）.Twenty nine metastatic SLNs were found in 19 patients in the combination group vs.21 in 17 patients in MB group.Conclusions ICG is a visible lymphatic mapping tracer helping visualize the SLNs.The use of ICG fluorescence and MB increases lymph node detection rate.

关 键 词：乳腺肿瘤 前哨淋巴结活组织检查 吲哚菁绿 

分 类 号：R737.9[医药卫生—肿瘤]