亚甲蓝在临床淋巴结阴性的乳腺癌患者前哨活检中的临床分析  

Clinical Analysis of Methylene Blue in Sentinel Biopsies of Patients With Clinical Node-negative Breast Cancer

作　　者：王金津 许玉春 WANG Jinjin;XU Yuchun(Department of Thyroid and Breast Surgery,Nanping First Hospital Affiliated to Fujian Medical University,Nanping Fujian 353000,China)

机构地区：[1]福建医科大学附属南平第一医院甲状腺乳腺外科,福建南平353000

出　　处：《中国卫生标准管理》2022年第18期106-110,共5页China Health Standard Management

基　　金：福建医科大学启航基金项目(2020QH1301)。

摘　　要：目的探讨亚甲蓝用于临床早期乳腺癌及腋窝淋巴结影像学检测阴性的前哨淋巴结活检(sentinel lymph node biopsy,SLNB)的临床分析。方法收集2020年4月—2022年3月在甲状腺乳腺外科住院的111例经彩超穿刺或活检证实临床淋巴结阴性(clinically node-negative,cN0)乳腺癌早期患者,采用亚甲蓝染色显像,行腋窝SLNB。结合术中SLNB结果决定是否行腋窝淋巴结清扫术(axillary lymph node dissection,ALND)。结果106例患者找到前哨淋巴结(sentinel lymph node,SLN),平均2.45枚,累计找到272枚。SLN冰冻或病理提示有癌转移以及未成功找到SLN者,均行ALND。所有患者未发生皮肤、全身过敏及皮肤坏死等并发症。结论亚甲蓝在早期乳腺癌SLNB中运用,安全有效,SLNB阴性结果避免ALND,有助于保护患侧上肢功能,提升生存质量,大大提高了早期乳腺癌保腋窝的成功率。Objective Methylene blue is used for the clinical analysis of the sentinel lymph node biopsy(SLNB)with a clinical early-stage breast cancer and a negative imaging test of the axillary lymph nodes.Methods We collected 111 early patients hospitalized in thyroid and breast surgery with clinically node-negative(cN0)breast cancer from April 2010 to March 2022,with methylene blue staining imaging and axillary sentinel node biopsy.Combined sentinel lymph node biopsy results were determined to perform axillary clearance.Results In 106 sentinel lymph node(SLN)were found,with an average of 2.45and 272 sentinel nodes were found.Axillary lymph node dissection axillary lymph node dissection(ALND)was performed in sentinel lymph node freezing or pathological indications of cancer metastasis,and in unsuccessful sentinel lymph node finding.All the patients did not develop complications such as skin,systemic allergy,and skin necrosis.Conclusion Methylene blue is safe,true and effective in the application of sentinel lymph node biopsy of early breast cancer.Avoid axillary lymph node dissection can help to protect the function of the upper limb on the affected side,improve the quality of life,and greatly improve the success rate of early breast axillary preservation.

关 键 词：亚甲蓝 前哨淋巴结 腋窝清扫 乳腺癌 上肢回流障碍 保腋窝 

分 类 号：R737[医药卫生—肿瘤]