吲哚菁绿+亚甲蓝示踪在腋窝淋巴结阴性早期乳腺癌患者前哨淋巴结病理诊断中的应用价值  

Application value of ICG+methylenum coeruleum tracer in SLNs pathological diagnosis of early breast cancer patients with negative axillary lymph nodes

作　　者：史源 SHI Yuan(Third Department of Surgery,Anyang Oncology Hospital,Anyang,Henan 455000,China)

机构地区：[1]安阳市肿瘤医院外三科,河南安阳455000

出　　处：《中国医学工程》2022年第9期43-47,共5页China Medical Engineering

基　　金：安阳市科技攻关计划项目(20784)。

摘　　要：目的 吲哚菁绿(ICG)+亚甲蓝示踪在腋窝淋巴结阴性早期乳腺癌患者前哨淋巴结(SLNs)病理诊断中的应用价值。方法 前瞻性收集2019年5月至2021年10月安阳市肿瘤医院外三科收治的腋窝淋巴结阴性早期乳腺癌患者200例,随机分为对照组(亚甲蓝组)及研究组(ICG+亚甲蓝组),各100例。根据前哨淋巴结活检术(SLNB)结果,两组患者中SLNs未转移者进行SLNB和腋窝Ⅰ、Ⅱ组淋巴结清扫,转移者则行腋窝淋巴结清扫(ALND)。统计两组患者SLNs检出数目、检出平均数目、阳性SLNs检出平均数等淋巴结检出情况,统计患者随访期间并发症发生情况。结果 对照组与研究组SLNs检出率分别为93.00%(93/100)、98.00%(98/100),二者比较差异无统计学意义(P>0.05);两组阳性SLNs出现的比率分别为29.00%、38.00%,比较差异无统计学意义(P>0.05)。研究组SLNs检出平均数目、阳性SLNs检出平均数目均高于对照组(P<0.05);研究组检出≥3枚SLNs与≥3枚SLNs阳性率高于对照组(P<0.05)。对照组假阴性率为6.45%(2/31),研究组假阴性率为5.00%(2/40)。研究组SLNs转移检出率高于对照组(P<0.05),两组SLNB的准确率、灵敏度及假阴性率比较差异无统计学意义(P>0.05)。术后患者总共随访了4~12个月,随访完成率为99.00%(198/200),且两组患者均未见明显并发症。结论 在腋窝淋巴结阴性早期乳腺癌患者SLNs病理诊断中,ICG+亚甲蓝示踪增加SLNs检出数量、SLNs阳性检出个数,且检出率较高,而假阴性率有降低趋势,可临床推广应用。【Objective】 To explore the application value of ICG+methylenum coeruleum tracer in SLNs pathological diagnosis of early breast cancer patients with negative axillary lymph nodes. 【Methods】 Two hundred patients with early breast cancer with negative axillary lymph nodes admitted to three departments of our hospital from May 2019 to October 2021 were prospectively randomized, they were randomly divided into the control group(methylenum coeruleum group) and the study group(ICG+methylenum coeruleum group), with 100 cases in each group. On the basis of sentinel lymph node biopsy(SLNB) results, the SLNB and axillary I, II group lymph node dissection was performed in patients without SLNs metastasis, and axillary lymph node dissection(ALND) was performed in metastasis patients. The number of detected SLNs, the average number of detected SLNs and detected positive SLNs were counted in the two groups, the postoperative was followed-up, and the incidence of complications during follow-up was analyzed. 【Results】 The detection rates of SLNs in control group and the study group were 93.00%(93/100),98.00%(98/100) separately, and the two groups were not significantly different(P>0.05);the rates of positive SLNs in the two groups were 29.00%, 38.00% spectively, the two groups were not significantly different(P>0.05). The average detected number of SLNs and the average detected number in study group of positive SLNs were higher than those in control group;the positive rates of ≥3 SLNs and ≥3 SLNs detected in study group were significantly higher than those in control group(P<0.05). The false negative rate was 6.45% in control group(2/31), and the false negative rate was 5.00% in study group(2/40), the detection rate of SLNs metastasis in study group was higher than that in control group(P<0.05), there was no significant difference in the ratio of accuracy,the sensitivity and false negative rate of SLNB between the two groups(P>0.05). The patients were followed up for a total of 4-12 months, and the follow-up compl

关 键 词：乳腺癌 前哨淋巴结活检术 吲哚菁绿 亚甲蓝 荧光示踪 

分 类 号：R737.9[医药卫生—肿瘤]