纳米碳混悬液示踪前哨淋巴结在早期乳腺癌诊治中的应用效果

Application of nano-carbon suspension in tracing sentinel lymph node in the diagnosis and treatment of early breast cancer

目的探讨纳米碳混悬液示踪前哨淋巴结(SLN)在早期乳腺癌诊治中的应用效果。方法依据随机数字表法将118例乳腺癌患者分为纳米碳组和对照组,每组59例。对照组使用体积分数为1%的亚甲蓝作为示踪剂,纳米碳组使用纳米碳混悬液作为示踪剂。两组患者均先行乳腺癌SLN活检术,再行腋窝淋巴结清扫术。以病理检查结果为金标准,评价两组SLN活检的灵敏度、特异度、准确度、约登指数、Kappa值及术中寻找SLN的时间。结果纳米碳组诊断SLN的灵敏度、准确度和约登指数分别为88.24%、94.92%和0.859,与病理诊断结果的Kappa值为0.869,均略高于对照组的82.35%、93.22%、0.800及0.817。纳米碳组和对照组术中寻找SLN的平均时间分别为(23.72±5.07)、(24.90±5.23)min,差异无统计学意义(P﹥0.05)。结论使用纳米碳混悬液或亚甲蓝作为示踪剂进行早期乳腺癌腋窝SLN活检均具有良好的检出情况,且两种示踪剂对SLN的诊断价值相当。

Objective To investigate the application of nano-carbon suspension in tracing sentinel lymph node(SLN)in the diagnosis and treatment of early breast cancer.Method One hundred eighteen patients with breast cancer were included and randomly categorized to nano-carbon group and control group using a random number table,including 59 cases in each.In the control group,methylene blue(1%)was used as a tracer,and in the nano-carbon group,nano-carbon suspension was employed.SLN biopsy of breast cancer was performed before axillary lymph node dissection.Using pathological findings as gold standard,the accuracy and sensitivity of SLN biopsy,Youden’s index,Kappa value and time for intraoperative SLN searching were evaluated in the two groups.Result The sensitivity,accuracy,and Youden’s index in diagnosing SLN in nano-carbon group were 88.24%,94.92%and 0.859,respectively,and the Kappa value versus pathological standard was 0.869,and these parameters were all higher compared to control group at 82.35%,93.22%,0.800 and 0.817,respectively.The average time spent searching for SLN in nano-carbon group and control group were(23.72±5.07)min and(24.90±5.23)min,respectively,indicating no statistical significance(P>0.05).Conclusion Using nanocarbon suspension or methylene blue as tracers for axillary SLN biopsy of early breast cancer confers good detection,and both tracers are equally effective in the diagnosis of SLN.