吲哚菁绿联合亚甲蓝在乳腺癌前哨淋巴结活检术中的应用研究

Application of Indocyanine green joint methylene blue for sentinel lymph node biophy in patients with breast cancer

目的:探讨吲哚菁绿联合亚甲蓝作为淋巴示踪剂在乳腺癌前哨淋巴结活检术(SLNB)中的应用价值。方法:选取于我院收治并确诊的原发性乳腺癌住院患者200例,随机分为实验组和对照组,各100例。实验组采用吲哚菁绿联合亚甲蓝作为淋巴示踪剂,对照组单用亚甲蓝为淋巴示踪剂,两组均先行常规SLNB再行腋窝淋巴结清扫术,两标本均送病理检查。结果:实验组检出率、灵敏度、假阴性率、一致率和Kappa值分别为98.00%(98/100)、95.74%(45/47)、4.26%(2/47)、96.94%%(95/98)和0.860;对照组检出率、灵敏度、假阴性率、一致率和Kappa值分别为94.00%(94/100)、86.96%(40/46)、13.04%(6/46)、93.62%(88/94)和0.758。两种检查方法的检出率、灵敏度、假阴性率、一致率和Kappa值比较,差异具有统计学意义(P<0.05)。结论:吲哚菁绿联合亚甲蓝作为淋巴示踪剂具有实时可视,定位精确等优点,可获更高检出率、准确率,同时降低假阴性率,为乳腺癌外科治疗提供了重要的循证医学依据。

Objective:To discuss the value of Indocyanine green joint methylene blue in sentinel lymph node biophy for patients with breast cancer.Methods:A total of 200 breast cancer patients were selected and randomly divided into test group and control group,with 100 cases in eachgroup.The test group received indocyanine green and methylene blue as the lymphatic mapping tracers and the control group received methylene blue only.Intraoperative frozen section was performed followed by conventional histopathology.Results:The positive rate,sensitivity,false negative rate,consistent rate and the Kappa values of the test group were 98.00%(98/100),95.74%(45/47),4.26%(2/47),96.94%(95/98)and 0.860,the corresponding data for the control group was 94.00%(94/100)and 86.96%(40/46),13.04%(6/46),93.62%(88/94)and 0.758 showing significant difference in positive rate,sensitivity,false negative rate,consistent rate and the Kappa values between the two groups(P<0.05).Conclusion:With advantages of real-time visual and accurate positioning,Indocyanine green joint methylene blue shows high positive rate,accuracy and low fake negative rate when it is used for sentinel lymph node biophy in patients with breast cancer.