纳米碳在乳腺癌前哨淋巴结活检中的临床应用

Application of a Carbon Nanoparticle Suspension Injection into the Mammary Gland in the Sentinel Lymph Node Biopsy for Breast Cancer

目的:初步探讨使用纳米碳混悬注射液在乳腺癌前哨淋巴结的示踪效果及影响因素。方法:2009年6月至2011年6月经本科确诊为T_1-T_2N_0M_0的早中期乳腺癌患156例,将纳米碳混悬液0.4～0.6 mL分4～6点注射到患者的乳腺组织上,30 min后行乳腺癌改良根治术(Auchincloss术式)或保乳术,找到距乳腺最近的黑染淋巴结定为SLN,其余为非SLN,分别送病理检查。结果:156例患者中,成功检出前哨淋巴结者152例,检出率为97.4%,准确率为92.3%(144/156),灵敏度为86.7%(52/60),假阴性率为133%(8/60),假阳性率为0。经统计学分析,检出率及假阴性率与患者临床分期、年龄、原发肿瘤部位、注射部位均无关。结论:应用纳米碳混悬注射液行前哨淋巴结活检可以准确预测早期乳腺癌患者的淋巴结状态,且示踪效果不受患者临床分期、年龄、原发肿瘤部位、注射部位的影响。

Objective： To conduct a preliminary study on the tracing effect and influence of a carbon nanoparticle suspension injection in the sentinel lymph node （ SLN ） biopsy of breast cancer. Methods： From June 2009 to June 2011, carbon nanoparticle suspension injections of 0.4 mL to 0.6 mL were injected into the mammary glands of 156 early-metaphase breast cancer patients at 4 to 6 points prior to breast cancer surgery. The lymph nodes were named SLN and non-SLN according their locations relative to the areola. Results： The detection rate of SLN was 97.4%. The false negative and sensitivity rates were 13.3% and 86.7%, respectively. Conclusion： Carbon nanoparticle suspension injections into the mammary gland in SLN biopsy are helpful for accurately evaluating the lymph node condition of breast cancer. The clinical stage, age, primary tumor site, and injection site do not affect the detection and false-negative rates.