三种不同示踪显示方案在乳腺癌手术中的临床价值对比研究

Comparative study of clinical value of three different tracer display schemes in breast cancer surgery

目的探讨三种不同示踪显示方案在乳腺癌手术中的临床价值。方法前瞻性选取2018年1月至2020年12月114例乳腺癌患者,采用随机数字表法将患者分为三组:MB组、ICG组和联合组,每组各38例。MB组采用亚甲蓝(MB)示踪法;ICG组采用吲哚菁绿(ICG)示踪法;联合组采用ICC+MB双示踪法。应用SPSS22.0软件处理数据,前哨淋巴结(SLN)检出率、准确率、假阴性率等计数资料行χ^(2)检验;肿瘤直径等计量资料以(x±s)表示,多组间比较行单因素方差分析,两组间比较行LSD-t检验分析。P<0.05为差异有统计学意义。结果MB组、ICG组及联合组患者SLN检出率分别为78.9%、94.7%、97.4%,SLN平均检出枚数分别为(2.1±0.8)、(2.5±0.9)、(2.8±1.1),MB组患者SLN检出率及平均检出枚数显著低于ICG组和联合组(P<0.05);联合组患者SLN检出准确率为95.6%,显著高于MB组的73.1%(χ^(2)=6.333,P=0.042);联合组SLN假阴性率(4.1%)显著低于MB组(17.6%),差异有统计学意义(χ^(2)=6.417,P=0.040)。结论ICG不论是单独应用还是联合应用均取得了较高的诊断价值,且ICC联合MB双示踪法更具有优势,不仅提高了SLN的检出数、检出率和准确率,而且更有利于降低SLN的假阴性率。

Objective To investigate the clinical value of three dfferent tracer display schemes in breast cancer surgery.MethodsA total of 114 breast cancer patients from January 2018 to December 2020 were prospectively selected and divided into three groups by random number table method:MB group,ICG group and combined group,with 38 cases in each group.Methylene blue(MB)tracer method was used in MB group.Indocyanine green(ICC)tracer was used in ICG group.ICG+MB double tracer was used in the combined group.SPSS 22.O sofware was used to process the data.The detection rate,accuracy rate and false negative rate of sentinel lymph node(SLN)were analyzed by χ^(2) test.Measurement data such as tumor diameter were expressed as(xs).One-way ANOVA of variance was used for comparison between multiple groups,and LSD-t test was used for comparison between two groups.P<0.05 was considered statistically significant.Results The detection rates of SLN in MB group,ICG group and combined group were 78.9%,94.7%and 97.4%,respectively.The average number of SLN detected was(2.1±0.8),(2.5±0.9)and(2.8±1.1),respectively.The detection rate and average number of SLN detected in MB group were significantly lower than those in ICG group and combined group(P<0.05).The detection accuracy of SLN in the combined group was 95.6%,which was significantly higher than that in the MB group(73.1%,χ^(2)=6.333,P=0.042).The false negative rate of SLN in combined group(4.1%)was significantly lower than that in MB group(17.6%),and the difference was statistically significant(χ^(2)=6.417,P=0.040).ConclusionICG alone or in combination has achieved high diagnostic value,and ICG combined with MB dual tracer method has more advantages,not only improves the detection number,detection rate and accuracy of SLN,but also is more conducive to reducing the false negative rate of SLN.