^(99)Tc^(m)-rituximab改良模式引导技术在原发性乳腺癌内乳前哨淋巴结活检的观察

An Observational Study of ^(99)Tc^(m)-rituximab Modified Pattern-Guided Technique in Internal Mammary Sentinel Lymph Node Biopsy of Primary Breast Cancer

目的探讨^(99)Tc^(m)-rituximab在乳腺癌内乳前哨淋巴结活检(IM-SLNB)中的应用,以及采用超声引导下大体积腺体内注射技术对乳腺癌患者内乳前哨淋巴结(IM-SLN)检出率的影响。资料与方法回顾性分析2017年9月—2022年1月福建省立医院行手术治疗的女性乳腺癌患者119例,根据注射部位分为3组:2针组45例,4针组19例,瘤周组55例。比较各组不同注射方法、注射部位的IM-SLN检出率及腋窝前哨淋巴结检出率及原发肿瘤位置对IM-SLN检出率的影响。结果2针组IMSLN(64.44%,29/45)和4针组IM-SLN的检出率(52.63%,10/19)均显著高于瘤周组IM-SLN(9.09%,5/55;χ^(2)=13.981、33.794,均P=0.000)。瘤周组与2针组及4针组检出的腋窝前哨淋巴结平均个数差异无统计学意义(2.38枚比2.46枚比2.53枚;χ^(2)=0.284,P=0.867)。原发肿瘤位置不同,IM-SLN检出率差异无统计学意义(χ^(2)=1.444,P=0.486)。结论采用超声引导下大体积腺体内注射技术后,^(99)Tc^(m)-rituximab引导的IM-SLNB检出率显著提高,为内乳区淋巴结活检创造了微创治疗的重要条件,并为准确的淋巴结分期提供了重要的技术支持。

Purpose To investigate the application of ^(99)Tc^(m)-rituximab in breast cancer internal mammary sentinel lymph node biopsy(IM-SLNB),and to evaluate the detection rate of internal mammary sentinel lymph node(IM-SLN)in breast cancer patients via ultrasoundguided intra-glandular injection technique.Materials and Methods A total of 119 female patients with breast cancer who underwent surgical treatment in Fujian Provincial Hospital from September 2017 to January 2022 were retrospectively analyzed.All patients were divided into 3 groups according to the injection site,including the 2 injection points group(n=45),the 4 injection points group(n=19),and the peritumoral group(n=55).The effects of different injection methods,injection sites on the detection rate of IM-SLN,axillary sentinel lymph node,and the location of the primary tumor on the detection rate of IM-SLN were compared among these three groups.Results The detection rate of IMSLN in the 2 injection point group(64.44%,29/45)and the 4 injection point group(52.63%,10/19)was significantly higher than those in the peritumoral group(9.09%,5/55;χ^(2)=13.981,33.794,all P=0.000),respectively.There was no significant difference in the average number of axillary sentinel lymph node among peritumoral,2 injection points and 4 injection points groups(2.38 vs.2.46 vs.2.53,χ^(2)=0.284,P=0.867).There was no significant difference in the detection rate of IM-SLN based on the different locations of primary tumors among peritumoral,2 injection points and 4 injection points groups(χ^(2)=1.444,P=0.486).Conclusion After ultrasound-guided gross glandular injection,the detection rate of IM-SLNB guided by ^(99)Tc^(m)-rituximab is significantly increased,which creates an important condition for minimally invasive treatment for internal breast lymph node biopsy and provides important technical support for accurate lymph node staging.