纳米炭序贯微量亚甲蓝在乳腺癌前哨淋巴结活检中的应用

目的 探讨纳米炭序贯微量亚甲蓝在乳腺癌前哨淋巴结活检中的应用价值.方法 选择2014年6月-2015年12月郑州大学第一附属医院乳腺外科收治的208例行乳腺癌前哨淋巴结活检术病例,根据注射染料的类型不同按随机数字表法分为序贯组(A组,128例),纳米炭组(B组,44例)以及亚甲蓝组(C组,36例).序贯组又根据亚甲蓝剂量不同按随机数字表法分为低剂量组(A1组,48例)、中剂量组(A2组,42例)、高剂量组(A3组,38例),行前哨淋巴结活检术,前哨淋巴结阴性不再行腋窝淋巴结清扫术.统计五组的检出率、淋巴管示踪状况、局部皮肤明显刺激发生率等数据.结果 (1)A、B、C组的检出率无明显差异,淋巴管示踪不理想的发生率B组高于A、C两组,局部皮肤明显刺激发生率C组高于A、B两组;(2)A1、A2、A3三组检出率及淋巴管示踪情况无明显差异,局部皮肤明显刺激发生率A3组高于A1、A2两组;(3)五组前哨淋巴结的检出率与患者年龄、BMI、肿瘤大小、肿瘤部位、肿瘤分子分型因素均无明显相关(均P＞0.05).结论 纳米炭序贯微量亚甲蓝检出率与两者单独应用时相当,但能减少单独使用纳米炭时出现淋巴管不显影的情况,又能减少大剂量亚甲蓝局部刺激问题,故可以作为临床上行前哨淋巴结活检术的良好选择.

Application of carbon nanoparticles followed by microscale methylthioninum chloride in sentinel lymph node biopsy for breast cancer

Objective To explore the application value of Carbon Nanoparticles followed by microscale Methylthioninum Chloride in sentinel lymph node biopsy for breast cancer.Methods Two hundred and eight breast cancer patients were selected in the First Affiliated Hospital of Zhengzhou University during recent two years who performed sentinel lymph node biopsy.They were randomly divided into five groups according to different lymphatic tracer injected:Sequential group (A group,128 patients),Carbon Nanoparticles group (B group,44 patients) and Methylthioninum Chloride group (C group,36 patients).According to different Methylthioninum Chloride doses,sequential groups were randomly divided into low dose group (A1 group,48 patients),middle dose group (A2 group,42 patients),high dose group (A3 group,38 patients),If sentinel lymph nodes were negative no longer performed axillary lymph nodes dissection.Receive the five groups statistics of detection rate,the condition of lymphatic tracer,the incidence of local skin irritation and so on.Results (1) The detection rate of A,B and C three groups had no obvious difference.The incidence of lymphatic tracer dyed not ideal in B group was higher than A and B two groups,the incidence of local skin stimulation in C group was higher than A and B two groups.(2) A1,A2,A3,three groups had no difference of the detection rate and lymphatic tracer,but the incidence of local skin stimulation in A3 group is higher than A1,A2 two groups.3.5 groups of SLN detection rate had no relationship with patients' age,BMI,tumor size,tumor location,tumor molecular classification factors (P ＞ 0.05).Conclusions Carbon Nanoparticles followed by microscale Methyhhioninum Chloride detection rate was similar with two separate application,but can reduce the lymphatic vessels not developing situation when used Carbon Nanoparticles alone and reduce the local irritation caused by large dose of Methylthioninum Chloride,so it can be a good choice of SLNB in clinical.