CAJ | 학술논문

目的探讨吲哚菁绿联合美蓝作为淋巴示踪剂在乳腺癌前哨淋巴结活检手术中的应用价值.方法 214例临床腋淋巴结阴性的早期乳腺癌患者随机分为两组,分别接受吲哚菁绿联合美蓝或者单用美蓝作为淋巴示踪剂.两组患者均进行常规前哨淋巴结活检手术.手术切除的前哨淋巴结送冰冻检查及常规石蜡和免疫组织化学病理检查.结果吲哚菁绿皮肤淋巴管显影103例,显影率为96.3％,淋巴结荧光显影102例,显影率为95.3％.联合组检出率98.1％ (105/107),美蓝组检出率93.4％ (100/107).联合组共检出前哨淋巴结325枚,平均3.1枚；美蓝组检出淋巴结总数242枚,平均2.4枚(t=-3.3,P=0.001).联合组检出腋窝淋巴结阳性患者19例,共检出转移淋巴结29枚,美蓝组检出腋窝淋巴结阳性患者17例,转移淋巴结21枚.结论自发荧光物质吲哚菁绿联合美蓝作为淋巴示踪剂具有良好的可视性,检出前哨淋巴结数量和腋淋巴结阳性患者多于单用美蓝方法.
목적 탐토신타정록연합미람작위림파시종제재유선암전초림파결활검수술중적응용개치.방법 214례림상액림파결음성적조기유선암환자수궤분위량조,분별접수신타정록연합미람혹자단용미람작위림파시종제.량조환자균진행상규전초림파결활검수술.수술절제적전초림파결송빙동검사급상규석사화면역조직화학병리검사.결과 신타정록피부림파관현영103례,현영솔위96.3％,림파결형광현영102례,현영솔위95.3％.연합조검출솔98.1％ (105/107),미람조검출솔93.4％ (100/107).연합조공검출전초림파결325매,평균3.1매；미람조검출림파결총수242매,평균2.4매(t=-3.3,P=0.001).연합조검출액와림파결양성환자19례,공검출전이림파결29매,미람조검출액와림파결양성환자17례,전이림파결21매.결론 자발형광물질신타정록연합미람작위림파시종제구유량호적가시성,검출전초림파결수량화액림파결양성환자다우단용미람방법.
Objective To evaluate intraoperative tracing of sentinel lymph node (SLN) by fluorescence imaging combined with methylene blue.Methods 214 early breast cancer patients eligible for sentinel lymph node biopsy were randomly assigned to combination group receiving indocyanine green (ICG) and methylene blue (MB) as the lymphatic mapping tracers and MB alone group.Intraoperative frozen section was performed,followed by conventional histopathology.Results In the combination group,subcutaneous lymphatic channels were successfully visualized in 103 patients and the detection rate was 96.3％.The fluorescence SLNs were successfully detected in 102 patients and the detection rate was 95.3％.In the combination group,sentinel lymph nodes were successfully identified in 105 patients,the SLNs detection rate was 98.1％.While in the dye alone group,the SLNs were found in 100 patients and the detection rate was 93.4％.The average number of detected SLNs was 3.1 (325/105) in combination group versus 2.4 (242/100) in dye alone group(t =-3.3,P =0.001).Twenty nine metastatic SLNs were found in 19 patients in the combination group vs.21 in 17 patients in MB group.Conclusions ICG is a visible lymphatic mapping tracer helping visualize the SLNs.The use of ICG fluorescence and MB increases lymph node detection rate.