荧光联合纳米炭在乳腺癌前哨淋巴结活检中的应用

目的 探讨乳腺癌前哨淋巴结活检(SLNB)中吲哚菁绿(ICG)联合纳米炭悬浊液的应用价值.方法 将110例腋窝淋巴结阴性的早期乳腺癌患者,随机分成两组,分别采用注射用ICG联合纳米炭悬浊液(联合组,57例)和单用纳米炭悬浊液(纳米炭组,53例)为示踪剂行SLNB.SLNB后随即行腋窝淋巴结清扫.结果 联合组中55例可见荧光所示淋巴管道,荧光显像率96.49%(55/57),前哨淋巴结检出率98.25%(56/57),准确率96.43%(54/56),假阴性率6.67%(2/30),灵敏度93.33%(28/30);纳米炭组前哨淋巴结检出率94.34%(50/53),准确率96.00%(48/50),假阴性率8.33%(2/24),灵敏度91.67%(22/24).联合组共检出前哨淋巴结309枚,纳米炭组共检出前哨淋巴结218枚,两组前哨淋巴结平均检出枚数比较差异有统计学意义(P<0.05);而两组检出率、准确率、假阴性率和灵敏度这4个评价指标比较,差异均无统计学意义.结论 ICG与纳米炭悬浊液联合应用相比单用纳米炭悬浊液可提高前哨淋巴结检出数量,减少漏诊概率.

Combination of fluorescence and carbon nanoparticles for mapping sentinel lymph nodes in early breast cancer patients

Objective To explore the feasibility of the combination of fluorescence and carbon nanoparticles as tracer for sentinel lymph node biopsy in early breast cancer patients. Methods 110 early breast cancer patients without clinical lymph node metastasis in axillary eligible for sentinel lymph node biopsy were randomly assigned to combination group (57 cases) receiving indocyanine green( ICG) and carbon nanoparticles as the lymphatic map-ping tracers and carbon nanoparticles alone group (53 cases). After sentinel lymph node biopsy,axillary lymph node dissection was performed. Results In the combination group,subcutaneous lymphatic channels were success-fully visualized in 55 patients and the detection rate was 98. 25%(56/57),and the accuracy,the false-negative rate,the sensitivity of SLNB were 96. 43%(54/56),6. 67%(2/30),93. 33% (28/30)respectively. In the carbon nanoparticles group,the detection rate ,the accuracy, the false-negative rate, the sensitivity of SLNB were 94. 34%(50/53),96. 00%(48/50), 8. 33%(2/24), 91. 67%(22/24). The number of detected SLN was 309 in combi-nation group venus 218 in carbon nanoparticles alone group. The difference of the average number of detected SLN was obvious between two groups(P<0. 05). However,there were no significant differences of the detection rate, the accuracy,the false-negative rate and the sensitivity of SLNB between the two groups. Conclusion Combina-tion of ICG and carbon nanoparticles for mapping SLN can inrease the number of the SLN detected and reduce the chance of misdiagnosis compared to using carbon nanoparticles alone.