乳腺癌前哨淋巴结活检染料选择的实验研究

Experimental study of the choice of vital dyes for sentinel lymph node biopsy in breast cancer

目的:通过观察1%异硫蓝(isosulfanblue,IB)、1%专利蓝(patentblue,PB)及1%美蓝(methyleneblue,MB)在大耳白家兔腋窝淋巴系统的运行特性,为乳腺癌前哨淋巴结活检(sentinellymphnodebiopsy,SLNB)染料选择提供实验依据。方法:30只雌性成年大耳白家兔随机分为3组,每组10只。观察前哨淋巴结(sentinellymphnode,SLN)和第二站淋巴结染色时间、染色枚数及褪色时间。结果:染料注射后到达SLN的时间IB组平均为20.6s;PB组平均为16.8s;MB组平均为14.7s,组间比较差异明显(P=0.040)。腋窝淋巴结染色枚数3组无明显差异(P=0.235)。肉眼观,淋巴结染色以MB组最深,IB组次之,而PB组最浅。第二站淋巴结染色时间IB组平均为45.8s,PB组为40.6s,两者比较无差异(P=0.257),MB组为23.5s,与前两者比较差异明显(均为P=0.000)。蓝染淋巴结的褪色时间以PB组最短,(6.4±0.9)min明显褪色,于(32.3±3.3)min完全褪色;IB组次之,(33.9±2.8)min可见明显褪色,于(64.2±2.4)min完全褪色;MB组最长,至6h淋巴结仍呈深染,组间比较差异明显(均为P=0.000)。结论:三种染料各具优缺点,效果相仿。

Objective: To observe the running feature of 1% isosulfan blue(IB), 1% patent blue(PB) and 1% methylene blue(MB) in the axillary lymph system of rabbits, and provide experimental evidence for the choice of ideal dye for the sentinel lymph node biopsy(SLNB) in breast cancer. Methods:Thirty female adult rabbits were randomly divided into three groups with 10 animals in each group. The dying time, the number and the fading time of the sentinel and the second lymph nodes were studied. Results:The average time from the vital blue injection of the second mammal in rabbits to sentinel lymph nodes being stained was 20.6,16.8,14.7 s(P = 0.040) by using IB,PB and MB respectively. There were no differences among different groups in the number of the dying nodes(P = 0.235). To observe by naked eyes, the lymph nodes were stained the most deeply by MB, secondly by IB, the most lightly by PB. The average dying time of the second lymph nodes stained by IB,PB,MB was 45.8,40.6,23.5 s. There was no obvious difference between the first two(P = 0.257),but the last one was distinctly different from the former two(P = 0.000). The average start and complete fading time of the lymph nodes stained by patent blue and isosulfan blue was 6.4 ± 0.9,33.9 ± 2.8 and 32.3 ± 3.3,64.2 ± 2.4 min,the lymph nodes were still stained deeply 6 h after stained by the methylene blue,and were distinctly different from the former two(P = 0.000). Conclusion:Each of vital dyes has its merits and demerits, and their effect has no obvious difference.