超声造影联合术中美蓝导航在早期乳腺癌精准腔镜前哨淋巴结活检中的临床应用价值  

Clinical application value of contrast-enhanced ultrasound combined with intraoperative navigation with methylene blue in precision endoscopic sentinel lymph node biopsy of early breast cancer

作　　者：赵英竹 韦文松 潘音桦[1] 胡巧[2] 李黎荟 王彬 何留生 陈晓艺 邹全庆[1] ZHAO Yingzhu;WEI Wensong;PAN Yinhua;HU Qiao;LI Lihui;WANG Bin;HE Liusheng;CHEN Xiaoyi;ZOU Quanqing(Department of Breast Surgery,the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences),Nanning 530021,China;Department of Ultrasound,the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences),Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院(广西医学科学院)乳腺外科,南宁530021 [2]广西壮族自治区人民医院(广西医学科学院)超声科,南宁530021

出　　处：《中国临床新医学》2024年第10期1098-1102,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西卫生健康委自筹经费科研课题(编号:Z-A20220037)。

摘　　要：目的探讨超声造影联合术中美蓝导航在早期乳腺癌精准腔镜前哨淋巴结活检中的临床应用价值。方法招募2022年7月至2024年6月广西壮族自治区人民医院乳腺外科收治的早期乳腺癌患者100例,随机分为研究组(超声造影联合术中美蓝导航)和对照组(仅美蓝导航)各50例。比较两组前哨淋巴结活检手术时间、前哨淋巴结检出率等。以病理检查结果为金标准,计算超声造影诊断的灵敏度、特异度和准确率。分析研究组超声造影与病理活检对前哨淋巴结性质判定的一致性。结果研究组和对照组的前哨淋巴结检出率分别为100.00%和84.00%,两组比较差异有统计学意义(χ^(2)=6.658,P=0.010)。研究组前哨淋巴结活检手术时间短于对照组,差异有统计学意义[(18.11±3.40)min vs(25.10±2.31)min;t=12.016,P<0.001]。超声造影诊断的灵敏度为78.57%,特异度为88.89%,准确率为86.00%。Kappa一致性检验结果显示,超声造影与病理活检在判定前哨淋巴结性质上具有高度一致性(Kappa=0.660,P<0.001)。结论超声造影联合术中美蓝导航在早期乳腺癌精准腔镜前哨淋巴结活检中对前哨淋巴结性质的判定与病理活检具有高度一致性,且检出率高,手术时间短,有助于提高临床诊疗水平,具有良好的实用性及前景。Objective To explore the clinical application value of contrast-enhanced ultrasound combined with intraoperative navigation with methylene blue in precision endoscopic sentinel lymph node biopsy of early breast cancer.Methods A total of 100 patients with early breast cancer who were admitted to Department of Breast Surgery,the People′s Hospital of Guangxi Zhuang Autonomous Region from July 2022 to June 2024 were recruited.The patients were randomly divided into research group(undergoing contrast-enhanced ultrasound combined with intraoperative navigation with methylene blue)and control group(undergoing intraoperative navigation with methylene blue only),with 50 cases in each group.The operation time and detectable rate of sentinel lymph nodes were compared between the two groups.The sensitivity rate,specificity rate and accuracy rate of the diagnosis of contrast-enhanced ultrasound were calculated by using the results of histopathological examination as the gold standard.In the research group,the consistency of contrast-enhanced ultrasound and pathological biopsy in determination of the nature of sentinel lymph nodes was analyzed.Results The detectable rates of sentinel lymph nodes in the research group and the control group were 100.00%and 84.00%,respectively,and the difference was statistically significant between the two groups(χ^(2)=6.658,P=0.010).The operation time of sentinel lymph node biopsy in the research group was shorter than that in the control group,and the difference was statistically significant[(18.11±3.40)min vs(25.10±2.31)min;t=12.016,P<0.001].The sensitivity rate,specificity rate and accuracy rate of the diagnosis of contrast-enhanced ultrasound were 78.57%,88.89%and 86.00%,respectively.The results of Kappa consistency test showed that contrast-enhanced ultrasound and pathological biopsy were highly consistent in determining the nature of sentinel lymph nodes(Kappa=0.660,P<0.001).Conclusion Contrast-enhanced ultrasound combined with intraoperative navigation with methylene blue is highly

关 键 词：乳腺癌 腔镜微创 超声造影 前哨淋巴结活检 

分 类 号：R737.9[医药卫生—肿瘤]