亚甲蓝和纳米炭混悬液在乳腺癌前哨淋巴结活检中的临床应用

Clinical research of sentinel lymph nodes biopsy in breast cancer by methylene blue and nanometres carbon suspension liquid

目的:比较亚甲蓝和纳米炭混悬液行乳腺癌前哨淋巴结活检(sentinel lymph nodes biopsy,SLNB)的成功率及临床价值。方法:从2007年5月我院收治乳腺癌患者中抽取86例(T1 T2),按注射染料的类型不同随机分为亚甲蓝组和纳米炭混悬液组,其中亚甲蓝组44例和纳米炭混悬液组42例。染料被分4点注入,乳晕周围皮下和乳腺组织中。30分钟后行前哨淋巴结活检术,再行腋窝淋巴结清扫术,并将前哨淋巴结及腋窝淋巴结送病理检查。结果:亚甲蓝组44例检出前哨淋巴结(Sentiel Lymph Nodes,SLN)41例(91.18%),SLNB的灵敏度为92.31%(12/13),准确率为90.91%(40/44),假阴性率为7.69%(1/13),假阳性率为0。纳米炭混悬液组42例,检出SLN40例(95.24%),SLNB的灵敏度为91.67%(11/12),准确率为92.86%(39/42),假阴性率为8.33%(1/12),假阳性率为0。两组间差异无显著性(P>0.05)。结论:采用亚甲蓝行乳腺癌SLNB的准确率和灵敏度与纳米炭混悬液相当,而亚甲蓝费用低廉更具有临床应用前景。

Objective：To compare the effect of methylene blue and nanometer carbon suspensor liquid in sentinel lymph nodes biopsy（SLNB）.Methods：86 female cases of breast cancer（T1 T2） were selected in our hospital during recent three years and divided into two groups according to different types of dye injection.44 cases were methylene blue group and the rest 42 cases were nanometer carbon suspension liquid group.The dye was subcutaneously injected at four points in breast gland tissues and periareolar skin.Sentinel lymph nodes biopsy for pathological examination was done after 30 min.Then axillary lymphnodes radical dissection was performed.Results：Sentinel lymph node（SLN） was detected in 44 cases of the methylene blue group,accounting for 91.18%.The sensitivity,accuracy,false-negative rate and false-positive rate in SLNB were 92.31%,90.91%,7.69% and 0%,respectively.Whereas SLN was detected in 40 cases（95.24%） of the manometer carbon suspension liquid group,its sensitivity,accuracy,false-negative rate and false-positive rate were 91.67%,92.86%,8.33% and 0% respectively.No significant difference existed between two groups（P0.05）.Conclusion：The accurate and sensitivity of two different dye methods in sentinel lymph nodes biopsy are similar.However methylene blue is cheaper with good application prospect in clinic.