荧光成像技术联合美蓝在乳腺癌术中探寻前哨淋巴结的应用价值

目的:探讨采用荧光成像技术联合美蓝示踪剂在女性乳腺癌手术治疗中探寻前哨淋巴结的临床应用价值.方法:选取我院收治的150例常规检测为原发性乳腺癌患者,随机分为3组,每组各50例,分别接受联合注射吲哚菁绿(indocyanine green,ICG)及美蓝(联合组)、单独注射ICG(ICG组)和单独注射美蓝(美蓝组)行前哨淋巴结活检手术(sentinel lymph node biopsy,SLNB),后将探寻的前哨淋巴结取出进行冰冻病理检查或常规石蜡病理检查.结果:联合组患者体外淋巴管显影率为94%(47/50),剩余3例有2例为切开后淋巴结显影,淋巴结荧光显影率为92%(46/50).联合组前哨淋巴结(sentinel lymph nodes,SLNs)的总检出率98%(49/50),检出SLNs数量为180枚,其中阳性患者10例(20.41%);ICG组的总检出率为90%(45/50),检出数量为158枚,阳性患者8例(17.78%);美蓝组的总检出率为88%(44/50),检出数量为150枚,阳性患者7例(15.91%);联合组相关观察指标均要优于ICG组和美蓝组.结论:ICG联合美蓝示踪法,相比单独注射ICG或美蓝,能明显提高乳腺癌患者前哨淋巴结的检出率和检出数量,为乳腺癌患者手术方案的选择提供更准确的指导.

Application value of fluorescence imaging technology combined with methylene blue tracer in sentinel lymph node biopsy for breast cancer

Objective: To investigate the clinical application of fluorescence imaging technology combined with methylene blue tracer in sentinel lymph node biopsy for breast cancer. Methods: A total of 150 patients with breast cancer were selected in this study. Of the patients, 50 cases underwent sentinel lymph node biopsy (SLNB) with indocyanine green (ICG) combined with methylene blue (the combination group), 50 cases underwent SLNB with ICG alone (the ICG group), while 50 cases underwent SLNB with methylene blue alone (the methylene blue group); intraoperative frozen section was performed, followed by conventional histopathology. Results: In the combination group, patients developing lymphatic vessels was 94% (47/50), and of the remaining three cases, two patients developed lymph node incision, lymph fluoroscopic visualization was 92% (46/50). The total detection rate of sentinel lymph nodes (SLNs) in the combination group was 98% (49/50) and the number of detected SLNs was 180, including 10 positive patients (20.41%); the total detection rate in the ICG group was 90% (45/50) and the detection number was 158, of which 8 patients was positive (17.78%); the total detection rate in the methylene blue group was 88% (44/50) and its detected number was 150, including 7 positive patients (15.91%);the related indicators in the combination group were higher than that in the ICG group or the methylene blue group. Conclusion: Compared to a single injection of ICG or methylene blue, ICG combined with methylene blue tracer method can significantly improve the detection rate and the number of the sentinel lymph node in breast cancer patients, which could provide an accurate guide on the selection of programs for breast cancer surgery.