同位素、蓝染、荧光法乳腺癌前哨淋巴结活检的临床应用研究

doi:10.3969/j.issn.1671-7171.2016.10.031

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Abstract 【Objective】The primary purpose of this study was to provide practical recommendations through determining the detection rate of three methods of sentinel lymph node (SLNB) biopsy: ICG fluorescence imaging, radioisotope(^99mTc) and blue dye.【Methods】Thirty-four women with clinically negative-node breast cancer underwent SLNB using radioisotope, blue dye and ICG. Detection rates of every method and combinations of any two or three tracers were analyzed. 【Results】 A total of 106 sentinel lymph nodes (SLNs) were dissected, with average SLN detecting number of 3.12 in each patient. Using the radioisotope method, 91 SLNs were identified and 2.68 SLNs were detected in each patient, with a detection rate of 85.8%. The SLN detection rates for ICG fluorescence imaging and blue dye method were 94.3% and 43.4%, respectively, with 91 and 46 SLNs were detected, respectively and 2.94 and 1.35 SLNs per patient, respectively. The identification rate for ICG fluorescence method in combination with the blue dye method was 94.3%, while it was 100% for ICG in combination with the radioisotope method. The number of identified SLNs was not significantly different (P>0.05) between the radioisotope and ICG method, but the number of identified SLNs was significantly different (P<0.05) between the isotope method in combination with the blue dye method and the fluorescence method in combination with blue dye method. SLNs were identified in 33/34 patients (97.1%) with either ICG fluorescence method alone or ICG fluorescence method in combination with the blue dye method; the detection rate was equivalent to the ^99mTc-labeled radiotracer method. The detection rate was 34/34 (100%) when the radioisotope method was combined with ICG or blue dye. 【Conclusion】Radioisotope method alone and combined with blue dye or fluorescence is preferred in detecting SLNs. Using fluorescence alone or combined with blue dye is a feasible and convenient procedure for clinical practice.

Key words： Sentinel Lymph Node Biopsy/MT Breast Neoplasms Isotopes/DU Methylene Blue/DU Fluorescent Dyes/DU

Received: 22 April 2016

PACS:

R737.9

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	Articles by authors
	ZHANG Kai-tong
	GUAN Shan
	WANG Yu

Cite this article:

ZHANG Kai-tong,GUAN Shan,WANG Yu. Investigation of Sentinel Lymph Node Biopsy by Radioisotope, Blue Dye and Fluorescence Methods for Breast Cancer[J]. JOURNAL OF CLINICAL RESEARCH, 2016, 33(10): 1963-1966.

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2016.10.031 OR http://www.jcr.net.cn/EN/Y2016/V33/I10/1963

[1] Krag DN, Anderson SJ, Julian TB,et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial[J] .Lancet Oncol,2010,11(10):927-933.
[2] Sagen A, Kaaresen R, Sandvik L, et al. Upper limb physical function and adverse effects after breast cancer surgery: a prospective 2.5-year follow-up study and preoperative measures[J] .Arch Phys Med Rehabil,2014,95(5):875-881.
[3] Lyman G H, Temin S, Edge S B, et al. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update[J] .J Clin Oncol,2014,32(13):1365-1383.
[4] 陆汉明,邵正才,裘建民. 前哨淋巴结活检在乳腺癌治疗中的应用[J] .肿瘤基础与临床,2008,21(5):422-424.
[5] Sadeghi R, Alesheikh G, Zakavi S R, et al. Added value of blue dye injection in sentinel node biopsy of breast cancer patients: do all patients need blue dye[J] .Int J Surg,2014,12(4):325-328.
[6] Barthelmes L. Adverse reactions to patent blue V dye - The NEW START and ALMANAC experience[J] .Eur J Surg Oncol,2010,36(4):399-403.
[7] Fazal N. Wahid, Alpin D. Malkan, Alberto Pappo, et al. Severe anaphylactic shock due to methylene blue dye[J] .J Ped Surg Case Reports,2014,2(3):117-118.
[8] 李太玉,孙晓,王永胜,等. 单用蓝染料示踪剂在乳腺癌前哨淋巴结活检中的价值[J] .中国普外基础与临床杂志,2010,17(12):1235-1239.
[9] Kohl S A, Leo C, Rufibach K, et al. Does increased tumor burden of sentinel nodes in breast cancer affect detection procedure[J] .Eur J Surg Oncol,2013,39(3):266-272.
[10] Gawlick U, Mone MC, Nelson ET, et al. Success in sentinel lymph node procedures in obese patients with breast cancer[J] .Am J Surg,2010,200(6):707-710, 710-711.
[11] Y LJ, Mcgowan K, Cooley G, et al. The role of ultrasound guided core biopsy of axillary nodes in predicting macrometastases and avoiding overtreatment outside ACOSOG Z0011 parameters[J] .Breast,2015,24(1):57-61.
[12] Hojo T.Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer[J] .Breast,2010,19(3):210-213.
[13] Ballardini B, Santoro L, Sangalli C, et al. The indocyanine green method is equivalent to the ^99mTc-labeled radiotracer method for identifying the sentinel node in breast cancer: a concordance and validation study[J] .Eur J Surg Oncol,2013,39(12):1332-1336.
[14] Wishart G C, Loh S W, Jones L, et al. A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer[J] .Eur J Surg Oncol,2012,38(8):651-656.
[15] Lo C, Lee PC, Yen RF, et al. Most frequent location of the sentinel lymph nodes[J] .Asian J Surg,2014,37(3):125-129.