示踪剂亚甲蓝注射液、纳米炭混悬液在乳腺癌前哨淋巴结活检术中的应用研究进展  

Research progress in the application of methylene blue injection and carbon nanoparticles suspension in sentinel lymph node biopsy of breast cancer

作　　者：王杰强 马德奎 WANG Jieqiang;MA Dekui(First School of Clinical Medicine,Guangdong Medical University,Guangdong Province,Zhanjiang524023,China;Breast Center,the First People′s Hospital of Zhaoqing Affiliated to Guangdong Medical University,Guangdong Province,Zhaoqing526000,China)

机构地区：[1]广东医科大学第一临床医学院,广东湛江524023 [2]广东医科大学附属肇庆市第一人民医院乳腺中心,广东肇庆526000

出　　处：《中国当代医药》2022年第29期37-41,共5页China Modern Medicine

摘　　要：2020年12月,国际癌症研究机构(IARC)公布了全球癌症统计数据,乳腺癌发病率首次超过了肺癌,成为全球最常见的癌症。乳腺癌发病率呈现逐年增长的趋势,手术治疗仍是早期乳腺癌的首选治疗方式,而区域淋巴结有无转移是评估乳腺癌预后的重要指标。前哨淋巴结是乳腺癌淋巴转移的第一站淋巴结,因此前哨淋巴结活检术已取代腋窝淋巴结清扫术,成为早期乳腺癌手术治疗的常规术式。前哨淋巴结活检术的准确性和成功率关键在于示踪剂的选择。良好的前哨淋巴结示踪剂应具备靶向性、可视性、操作简便、价格低廉及不良反应少等特点。近些年来,随着技术不断改进,寻找前哨淋巴结的方法层出不穷,尽管目前指南指出染料法联合放射性核素法双示踪为前哨淋巴结活检术的金标准,但因核素法的缺点较多,临床上以染料法居多。目前应用比较广泛的示踪剂为亚甲蓝注射液,亚甲蓝注射液对淋巴结的靶向性差,存在一定的局限性。随着对示踪剂的研发和改进,发现纳米炭混悬液在前哨淋巴结活检术中有良好的淋巴结趋向性。因此本文针对上述两种示踪剂的异同,对亚甲蓝注射液与纳米炭混悬液两种示踪剂的特点、作用原理、注射剂量、显影情况及不良反应等方面进行对比,旨在为临床运用提供参考,提高前哨淋巴结活检术的准确性和成功率。In December 2020,the International Agency for Research on Cancer(IARC)released global cancer statistics that for the first time the incidence of breast cancer has surpassed lung cancer as the most common cancer worldwide.The incidence of breast cancer is increasing year by year.Surgical treatment is still the preferred treatment for early breast cancer,and whether regional lymph node metastasis is an important indicator to evaluate the prognosis of breast cancer.Sentinel lymph node is the first station of lymph node metastasis of breast cancer,so sentinel lymph node biopsy has replaced axillary lymph node dissection as a routine surgical treatment for early breast cancer.The key to the accuracy and success rate of sentinel lymph node biopsy is the choice of tracer.excellent sentinel lymph node tracers should include the characteristics of targeting,visibility,simple operation,low cost and few adverse reactions.In recent years,with the continuous improvement of technology,methods to search for sentinel lymph nodes have emerged in an endless fashion.Although the current guidelines point out that dye method combined with radionuclide method is the gold standard for sentinel lymph node biopsy.dye method is the dominant method in clinical practice due to many shortcomings of the nuclide method.At present,methylene blue injection is widely used as a tracer.Methylene blue injection has poor targeting ability to lymph nodes and it has certain limitations.With the development and improvement of the tracer,it was found that the carbon nanoparticles suspension had well lymph node taxis in sentinel lymph node biopsy.In order to provide reference for clinical applicationand and improve the accuracy and success rate of sentinel lymph node biopsy,the article introduce the characteristics,action principle,injection dose,development and adverse reactions of methylene blue and nano-carbon for comparison.

关 键 词：乳腺癌 前哨淋巴结活检术 示踪剂 亚甲蓝注射液 纳米炭混悬液 

分 类 号：R737.9[医药卫生—肿瘤]