CAJ | 학술논문

目的通过与亚甲蓝(MB)示踪法比较,探讨超声造影检测乳腺癌前哨淋巴结(SLN)的前景.方法建立兔VX2乳腺癌模型24只,皮下注射SonoVue,超声造影显像SLN,观察其造影增强情况;再经皮下注射MB示踪;行腋窝淋巴结清扫术切除前哨淋巴结(sentinel lymph node,SLN)并行AE1/AE3免疫组化染色.结果 24只荷瘤兔超声造影检出回声均匀性增强的SLN 12个,回声不均匀性增强和部分充盈缺损的SLN 22个;MB示踪法检出SLN 32个;术中腋窝淋巴结清扫SLN 38个.以手术切除的SLN免疫组化结果为标准,超声造影的检出率(89.47%)、敏感性(95.24%)与MB示踪法检出率(84.21%)、敏感性(91.30%)比较无显著差异(P>0.05);但其特异性(84.62%)和准确性(91.18%) 均明显高于MB示踪法特异性(26.67%)和准确性(65.79%)(P<0.05).结论经皮下注射超声造影剂显像乳腺癌SLN与MB示踪法比较有一定优势,有望成为检测SLN的常用方法.
목적 통과여아갑람(MB)시종법비교,탐토초성조영검측유선암전초림파결(SLN)적전경.방법 건립토VX2유선암모형24지,피하주사SonoVue,초성조영현상SLN,관찰기조영증강정황;재경피하주사MB시종;행액와림파결청소술절제전초림파결(sentinel lymph node,SLN)병행AE1/AE3면역조화염색.결과 24지하류토초성조영검출회성균균성증강적SLN 12개,회성불균균성증강화부분충영결손적SLN 22개;MB시종법검출SLN 32개;술중액와림파결청소SLN 38개.이수술절제적SLN면역조화결과 위표준,초성조영적검출솔(89.47%)、민감성(95.24%)여MB시종법검출솔(84.21%)、민감성(91.30%)비교무현저차이(P>0.05);단기특이성(84.62%)화준학성(91.18%) 균명현고우MB시종법특이성(26.67%)화준학성(65.79%)(P<0.05).결론 경피하주사초성조영제현상유선암SLN여MB시종법비교유일정우세,유망성위검측SLN적상용방법.
Objective To explore the prospects of contrast-enhanced ultrasound and methylene blue(MB)detection of breast cancer sentinel lymph node (SLN).Methods Twenty-four rabbit models of VX2 breast cancer were set up with subcutaneous injection of SonoVue to get contrast-enhanced ultrasound imaging of SLN.The situation of contrast-enhanced SLN was observed.Then subcutaneous injection of MB was performed to trace SLN.SLN was resected from axillary lymph nods,which underwent immuno-histochemistry of AE1/AE3.Results Among the twenty-four rabbits,12 SLN were with homogeneous echo-enhanced.22 SLN enhanced non-uniformities were found by contrast-enhanced ultrasound.By MB tracer method 32 SLN were detected.38 SLN were resected from axillary lymph nodes.To make surgical resection as the standard,the detection rate of contrast-enhanced ultrasound (89.47%) and the MB tracer detection rate (84.21%) showed no significant difference (P>0.05).Contrast-enhanced ultrasound sensitivity (95.24%) and the MB tracer method sensitivity (91.30%) showed no significant difference (P>0.05),but the specificity (84.62%) and accuracy (91.18%) from contrast-enhanced ultrasound sensitivity were significantly higher than those from tracer MB method[specificity(26.67%) and accuracy(65.79%)](P<0.05).Conclusions Contrast-enhanced ultrasound imaging in detecting SLN of breast cancer gets a higher detection rate,specificity,accuracy and sensitivity compared with the MB tracer method,which is expected to become the common method in detection of SLN.