不同浓度和剂量3种示踪剂应用于甲状腺前哨淋巴结活检的实验研究

Experimental study of sentinel lymph node biopsy in thyroid by using three kinds of vital dyes at different concentration and dose

目的:通过应用不同浓度和剂量的异硫蓝(IB)、专利蓝(PB)及美蓝(MB)于兔甲状腺,观察其在兔甲状腺前哨淋巴结(SLN)活检中的作用,为甲状腺癌患者SLN活检示踪剂的选择提供实验依据。方法:36只成年兔随机分为9组,每组4只。分别将1%-0.01ml,1%-0.02ml,2%-0.02ml的IB、PB、MB注入各组兔甲状腺左右叶,观察SLN的染色枚数,显色时间及明显、完全褪色时间。结果:9组实验中每侧兔颈部检出的SLN在1～3枚之间,9组间差异无统计学意义。9组实验中,SLN平均显色时间最短为2%MB0.02ml组,6.3s;平均明显褪色时间最长为2%MB0.02ml组,28.2min;1%MB0.02ml组与2%MB0.02ml组观察至40min后染色SLN仍可辨别。结论:2%MB0.02ml注射时,SLN染色较深,显色较快,褪色时间较长,为甲状腺SLN活检应用较佳的示踪剂。

Objective：Using isosulfan blue（IB）,patent blue（PB） and methylene blue（MB） at different concentration and dose in the thyroid of rabbits, to study the role of them in the sentinel lymph node（SLN） biopsy in rabbit and to provide experimental evidence for the choice of ideal dye of the sentinel lymph node biopsy in thyroid cancer patients. Method： Thirty-six adult rabbits were randomly divided into nine groups with four rabbits in each group. After 1%- 0.01 ml.1%- 0.02 ml,2% 0.02 ml of IB,PB, MB were separately injected in the thyroid of rabbit, the number of SLNs and the dying time, and the beginning and complete fading time of the SLNs were observed. Result.. One to 3 SLNs were identified in the one side neck of rabbits and there were no significant difference among different groups . The average time from the vital blue injection in the thyroid to SLN being stained was 6.3s by using 20/00 MB 0.02 ml, which was the shortest. The lymph nodes stained by 2% MB 0.02 ml began to fade after 28.2 min, and the lasting time is the longest. The SLNs stained by using 1% MB 0.02 ml or 20/00 MB 0.02 ml can be identified after 40 mins. Conelusion..The study confirmed that 20/00 MB 0.02 ml were better than the other vital dyes for sentinel lymph node biopsy. The lymph nodes were stained by 2 % MB 0.02 ml deeply and the dying time is the shortest, while the lasting time is thelongest.