吲哚菁绿在乳腺癌前哨淋巴结活检中的应用及其量效分析

发布时间：2018-03-24 11:52

本文选题：乳腺肿瘤　切入点：前哨淋巴结活检　出处：《上海交通大学学报(医学版)》2017年12期

【摘要】：目的·研究不同浓度的吲哚菁绿(ICG)在前哨淋巴结活检(SLNB)中皮下淋巴管及淋巴结的显影情况,寻找最佳浓度以提高SLNB的成功率。方法·选择2015年1月—2017年5月临床腋窝淋巴结阴性的原发性乳腺癌患者339例,采用ICG和亚甲蓝双示踪法行SLNB。浓度为1.25 mg/mL的ICG原液,稀释至不同浓度,注射体积1 mL;亚甲蓝注射1 mL(10 mg/mL)。记录注射不同浓度的ICG后,皮下淋巴管、淋巴结的显影情况及SLNB成功率。结果·ICG浓度对淋巴管及淋巴结显影率和最终活检成功率有影响(P=0.001)。在肿瘤位于乳房非外上象限(穿刺活检或手术切除活检)及肿瘤位于外上象限未行切除活检(穿刺活检)组中,达到80%的皮下淋巴管显影率的ICG浓度为0.723 mg/mL(95%CI为0.595~0.915 mg/mL)。该浓度范围在这组患者中皮下淋巴结显影率为28%~53%,SLNB成功率为88%~92%;在肿瘤位于外上象限且已切除组中,皮下淋巴管和淋巴结显影率分别为50%~69%和20%~42%,SLNB成功率为76%~81%。2组的皮下淋巴管显影率差异有统计学意义(P=0.014),淋巴结显影及SLNB成功率差异无统计学意义(P=0.628,P=0.232)。结论·ICG荧光法+亚甲蓝染色法的双示踪法行SLNB简单易行且活检成功率高,ICG最佳浓度为0.723 mg/mL,可提高淋巴管及淋巴结的显影率。
[Abstract]:Objective to study the development of subcutaneous lymphatic vessels and lymph nodes in sentinel lymph node biopsy (SLNB) with different concentrations of indocyanine green (ICG). Methods from January 2015 to May 2017, 339 patients with primary breast cancer with negative axillary lymph nodes were selected, and ICG and methylene blue double tracer method were used to detect SLNB.The concentration of ICG was 1.25 mg/mL. Dilute to different concentrations, volume 1 mL, methylene blue 1 mL(10 mg / mL. Record subcutaneous lymphatic vessels after different concentrations of ICG. Results the concentration of ICG had an effect on lymphatic vessel and lymph node imaging rate and final biopsy success rate. The tumor was located in the nonexternal superior quadrant of breast (puncture biopsy or surgical biopsy) and tumor. In the excision biopsy (puncture biopsy) group in the outer upper quadrant, The ICG concentration of 80% subcutaneous lymphatic vessel development rate was 0.723 mg/mL(95%CI, 0.595 卤0.915 mg / mL. The subcutaneous lymph node development rate in this group was 28% and the success rate of SLNB was 88%. In the tumor group, the tumor was located in the outer upper quadrant and had been resected. The development rate of subcutaneous lymphatic vessels and lymph nodes were 50% and 20%, respectively. The success rate of subcutaneous lymphatic vessel development was 76% and 81.2%, respectively. There was significant difference in subcutaneous lymphatic vessel development rate between the two groups. There was no significant difference in lymph node development and SLNB success rate. Conclusion ICG fluorescence method has no significant difference in subcutaneous lymphatic development. Conclusion there is no significant difference in subcutaneous lymphatic development and SLNB. Conclusion ICG fluorescence method has no significant difference in subcutaneous lymphatic development. The double tracer method of blue staining was easy to perform and the successful rate of biopsy was high. The best concentration of ICG was 0.723 mg / mL, which could improve the imaging rate of lymphatic vessels and lymph nodes.
【作者单位】：上海交通大学医学院附属国际和平妇幼保健院乳腺科;同济大学附属杨浦医院乳腺外科;
【基金】：同济大学附属杨浦医院院级课题(Ser1201522) 上海交通大学医学院附属国际和平妇幼保健院院级课题(Jes150354)~~
【分类号】：R737.9

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