纳米炭示踪前哨淋巴结在早期乳腺癌治疗中的价值  

Significance of carbon nanoparticle tracking sentinel lymph node in the therapy for early breast carcinoma

作　　者：徐旭东 沈汉斌 黄继玲 赵倩 于洋 殷雪 罗智勇[2] 吴亚群[2] 

机构地区：[1]武汉市第五医院肿瘤综合外科,武汉430050 [2]华中科技大学同济医学院附属同济医院甲乳外科,武汉430030

出　　处：《国际外科学杂志》2015年第9期612-615,共4页International Journal of Surgery

摘　　要：目的 探讨纳米炭混悬液示踪乳腺癌前哨淋巴结的可行性及实用性,进一步探索纳米炭示踪的前哨淋巴结活检在早期乳腺癌治疗中的意义.方法 346例T 1 ～ 2N0M0乳腺癌患者按均衡随机化方法随机分为美蓝组和纳米炭组,分别于术前30 min经乳晕周围皮下注射美蓝与纳米炭,随后行前哨淋巴结定位活检.结果 美蓝组前哨淋巴结活检的成功率为81.6％,纳米炭组前哨淋巴结活检的成功率为93.1％,两组前哨淋巴结活检的成功率差异有统计学意义（P＜0.05）.美蓝组前哨淋巴结活检的灵敏度为94.3％,假阴性率为5.7％.纳米炭组前哨淋巴结活检的灵敏度为95.4％,假阴性率为4.6％,两组前哨淋巴结活检的灵敏度和假阴性率比较差异均无统计学意义（P＞0.05）.美蓝组和纳米炭组前哨淋巴结活检的准确率分别为75.9％和91.5％,两组比较差异有统计学意义（P＜0.05）.在美蓝组,临床T1期乳腺癌染色成功率明显高于T2期（P＜0.05）.而在纳米炭组,临床T1期和T2期乳腺癌染色成功率差异无统计学意义（P＞0.05）.结论 以纳米炭示踪前哨淋巴结能准确反映早期乳腺癌腋窝淋巴结状态,对乳腺癌治疗方式的选择具有重要的现实意义.Objective To explore the feasibility and validity of sentinel lymph node in breast carcinoma tracking through carbon nanoparticle suspension.We then investigated the significance of sentinel lymph node biopsy to therapy in early breast carcinoma with the help of carbon nanoparticle.Methods Three hundred and forty-six earlyphase breast carcinoma patients entered the study.They were divided into methylene blue group and carbon nanoparticle group in terms of balanced random groups.Methylene blue group and carbon nanoparticle were respectively injected into subcutaneous tissue around areola at 30 rmin before operation.Then we carried out the allocation of sentinel lymph node biopsy.Results In methylene blue group, the success rate of SLNB was 81.6％, while the success rate of SLNB was 93.1％ in carbon nanoparticle group, there were obvious differences between two groups （P ＜0.05）.The sensitivity and false negative rates were 94.3％ and 5.7％ in methylene blue group, while the sensitivity and false negative rates were 95.4％ and 4.6％ in carbon nanoparticle group, there were no significant differences（P ＞0.05）.However, the correct rate in carbon nanoparticle group was markedly higher than that in methylene blue group（P ＜ 0.05）.In methylene blue group, the success rate of dyeing in T1 phase breast carcinoma was significantly higher than that in T2 phase breast carcinoma（P ＜ 0.05）.But there were no obvious differences between T1 and T2 phase breast carcinoma in carbon nanoparticle group（P ＞0.05）.Conclusions Tracing sentinel lymph node through carbon nanoparticle suspension can accurately evaluate axillary lymph node conditions of early breast carcinoma.It plays an important role in therapy choices for breast carcinoma.

关 键 词：纳米炭 前哨淋巴结活组织检查 乳腺肿瘤 早期诊断 

分 类 号：R737.9[医药卫生—肿瘤]