纳米炭混悬液与美蓝在乳腺癌前哨淋巴结活检中的应用研究

Clinical Research of Carbon Nanoparticles Suspension and Methylene Blue in Sentinel Lymph Node Biopsy for Breast Cancer

目的探讨纳米炭混悬液与美蓝在乳腺癌前哨淋巴结活检中的应用价值和优势。方法收集303例临床腋窝淋巴结阴性且进行了前哨淋巴结活检手术的早中期乳腺癌病例,依据使用纳米炭混悬液或者美蓝作为淋巴结示踪剂分为两组,其中纳米炭组138例,美蓝组165例。手术切除的前哨淋巴结送病理检查。结果纳米炭组检出率为99.3%,美蓝组检出率为93.9%,使用纳米炭混悬液SLN检出率高于使用美蓝者(P<0.05)。纳米炭组共检出SLN 696枚,平均5.1枚,美蓝组检出SLN 544枚,平均3.5枚(P=0.000),使用纳米炭混悬液检出的SLN比美蓝要多。使用美蓝时,出现示踪不理想的概率高于纳米炭(P<0.05)。使用上述两种示踪剂的检出率与患者肿瘤大小、肿瘤部位、术前腋窝淋巴结触诊情况、肿瘤分子分型、年龄、肥胖因素均无关(P均>0.05)。结论纳米炭混悬液示踪效果好,能检出更多的SLN,SLN检出率更高。

Objective To evaluate the efficacy and advantages of carbon nanoparticles suspension( CNPS) and methylene blue( MB) as a tracer in sentinel lymph node biopsy( SLNB) for breast cancer. Methods 303 breast cancer patients who performed sentinel lymph node biopsy were divided into 2 groups according to different lymphatic mapping tracer injected. 138 patients injected CNPS,and 165 patients injected MB. SLN received pathological detection. Results The identification rate of CNPS group was 99. 3%,which was significantly higher than that of MB group( 93. 9%,P < 0. 05). The average number of sentinel lymph node( SLN) was 5. 1 in CNPS group versus 3. 5 in MB group( P = 0. 000). A higher ratio of getting unsatisfied dyeing results occurred in MB group( P < 0. 05). The identification rate of the 2 groups were not significantly associated with tumor size,location,preoperative lymph nodes palpation results,tumor molecular subtypes,age or obesity( all P > 0. 05). Conclusion CNPS is an ideal tracer for SLNB,it has higher diagnosis rate and can identify more SLN.