吲哚菁绿在乳腺癌前哨淋巴结活检中的应用观察.PDF

　 军 杂 2015年5月1 日　第40卷　第5期 392 解放 医学 志　 论　著 吲哚菁绿在乳腺癌前哨淋巴结活检中的应用观察 寇德强，邱镜丹，王全胜，王建东 [摘要]　目的　探讨吲哚菁绿(ICG)单独应用于乳腺癌前哨淋巴结(SLN)活检的临床应用前景。方法　选择2014 年7 －12月接受手术的72例女性乳腺癌患者，年龄33~67岁，中位年龄50岁，随机分为实验组(n=35)和对照组(n=37) ， 分别以ICG 和亚甲蓝作为示踪剂实施SLN活检。手术切除标本送快速冰冻病理检测，证实存在SLN转移者，行腋窝淋 巴结清扫，SLN 阴性者不行腋窝淋巴结清扫。结果　ICG法检出率为94.3% ，成功检出SLN 111个，平均每例检出3.2个 SLN ，准确率94.3% ，灵敏度100% ，假阴性率0% ；亚甲蓝法检出率为91.9% ，成功检出SLN 78个，平均每例检出2.1个 SLN ，准确率89.2% ，灵敏度92.9% ，假阴性率为7.7% 。两组平均检出个数和假阴性率差异有统计学意义(P 0.05) ，检出 率、准确率、灵敏度差异无统计学意义(P 0.05) 。结论　采用ICG法进行SLN活检成功率高，假阴性率低，临床效果优 于亚甲蓝法，有望单独应用于乳腺癌SLN活检。 [关键词]　乳腺肿瘤；前哨淋巴结活组织活检；吲哚花青绿；亚甲蓝 [中图分类号]　R737.9　　　　[文献标志码]　A　　　　[文章编号]　0577-7402(2015)05-0392-04 [DOI]　10.11855/j.issn.0577-7402.2015.05.12 The use of indocyanine green in sentinel lymph node biopsy in patients with breast cancer * KOU De-qiang, QIU Jing-dan, WANG Quan-sheng, WANG Jian-dong Department of General Surgery, General Hospital of PLA, Beijing 100853, China * Corresponding author, E-mail: vicky1968@163.com This work was supported by the Natural Science Foundation of Beijing (7142151), and the M ilitary Medical Innovation Special Plan (13CXZ058) [Abstract]　Objective　To explore the prospect of clinical application of indocyanine green (ICG) in sentinel lymph node biopsy (SLNB) in patients with breast cancer. Methods　Seventy-two female breast cancer patients were selected from those receiving surgery during July 2014 and December 2014, with an age range of 33-67 years and a median age of 50 years, and they were randomly divided into experimental group ( n=35) and control group (n=37), ICG and methylene blue as tracers were used respectively for SLNB. The surgical specimens were submitted to frozen section for pathological examination. The patients with metastasis to SLN received axillary lymph node dissectio