吲哚菁绿荧光法在乳腺癌前哨淋巴结活检中的应用  

Clinical Application of Indocyanine Green Fluorescence in Sentinel Lymph Nodes Biopsy for Breast Cancer

作　　者：龚晓军[1] 毛红岩[1] 刘慧民[1] 白海亚[1] 杨萍[1] 

机构地区：[1]甘肃省妇幼保健院乳腺二科,甘肃兰州730050

出　　处：《中国普外基础与临床杂志》2016年第2期221-224,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的评价吲哚菁绿荧光(ICG)法在乳腺癌患者前哨淋巴结活检(SLNB)中的应用价值。方法对2014年2月至2015年3月期间在我院住院且行SLNB的66例乳腺癌患者的临床资料进行回顾性分析,66例患者分别应用ICG法(ICG组,34例)和美蓝染色法(美蓝组,32例)来预测腋窝淋巴结转移情况,对此进行比较。结果所有66例患者中检出前哨淋巴结患者共59例,检出率为89.39%(59/66)。59例检出前哨淋巴结患者中共检出前哨淋巴结162枚,平均2.75枚/例。检出时间为(5.05±1.52)min。在ICG组前哨淋巴结检出率为97.06%(33/34),美蓝组前哨淋巴结检出率为81.25%(26/32),ICG组的前哨淋巴结检出率明显高于美蓝组(P<0.05)。59例检出前哨淋巴结中有32例是前哨淋巴结阳性,其中ICG组20例,美蓝组12例。所有患者均行ALND,有35例发现腋窝淋巴结转移,其中ICG组21例,美蓝组14例。ICG组和美蓝组的灵敏度和假阴性率比较差异无统计学意义(95.2%比85.7%,P>0.05;4.8%比14.3%,P>0.05)。结论 ICG法在乳腺癌患者SLNB的应用中的检出率明显高于美蓝组,且具有操作简单、灵敏度高的特点。Objective To evaluate clinical value of indocyanine green（ICG） fluorescence in sentinel lymph node（SLN） biopsy（SLNB） for breast cancer. Method The SLNBs were performed in 66 patients with breast cancer, who were divided into ICG group（n=34） and methylene blue dye group（n=32） according to the tracing method. Results The SLNs were found in 59 patients, the detection rate was 89.39%（59/66）. One hundred and sixty-two SLNs in 59 patients were detected, the average number of detected SLNs was 2.75. The SLNs detection rate was 97.06%（33/34） and 81.25%（26/32） in the ICG group and in the methylene blue dye group, respectively, which in the ICG group was significantly higher than that in the methylene blue dye group（P〈0.05）. The positive SLNs were found in 32 cases, within which was 20 cases in the ICG group, 12 cases in the methylene blue dye group. The axillary lymph node metastases were found in 35 of 66 cases, within which was 21 cases in the ICG group, 14 cases in the methylene blue dye group. The sensitivity and false negative rate had no significant differences between the ICG group and the methylene blue dye group（sensitivity： 95.2% versus 85.7%, P〈0.05; false negative rate： 4.8% versus 14.3%, P〈0.05）. Conclusion The ICG fluorescence in SLNB for breast cancer has many advantages, including shorter time, simple operation, high sensitivity, and high detection rate as compared with methylene blue dye.

关 键 词：乳腺癌 前哨淋巴结 吲哚菁绿 美蓝染色 

分 类 号：R737.9[医药卫生—肿瘤]