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目的:探讨采用荧光成像技术联合美蓝示踪剂在女性乳腺癌手术治疗中探寻前哨淋巴结的临床应用价值。方法:选取我院收治的150例常规检测为原发性乳腺癌患者,随机分为3组,每组各50例,分别接受联合注射吲哚菁绿(indoc yanine green,ICG)及美蓝(联合组)、单独注射ICG(ICG组)和单独注射美蓝(美蓝组)行前哨淋巴结活检手术(sentinel lymph node biopsy,SLNB),后将探寻的前哨淋巴结取出进行冰冻病理检查或常规石蜡病理检查。结果:联合组患者体外淋巴管显影率为94%(47/50),剩余3例有2例为切开后淋巴结显影,淋巴结荧光显影率为92%(46/50)。联合组前哨淋巴结(sentinel lymph nodes,SLNs)的总检出率98%(49/50),检出SLNs数量为180枚,其中阳性患者10例(20.41%);ICG组的总检出率为90%(45/50),检出数量为158枚,阳性患者8例(17.78%);美蓝组的总检出率为88%(44/50),检出数量为150枚,阳性患者7例(15.91%);联合组相关观察指标均要优于ICG组和美蓝组。结论:ICG联合美蓝示踪法,相比单独注射ICG或美蓝,能明显提高乳腺癌患者前哨淋巴结的检出率和检出数量,为乳腺癌患者手术方案的选择提供更准确的指导。
Objective: To explore the clinical value of fluorescence imaging combined with methylene blue tracer in exploring the surgical treatment of sentinel lymph nodes in female breast cancer. Methods: One hundred and fifty cases of primary breast cancer who were admitted to our hospital were randomly divided into 3 groups (n = 50 in each group), receiving indocine green (ICG) and methylene blue (ICG group) and sentinel lymph node biopsy (SLNB) injected with methylene blue (methylene blue) respectively. The sentinel lymph nodes were removed for frozen pathological examination or routine paraffin pathology an examination. Results: The lymphatic imaging rate was 94% (47/50) in the combined group and 2 cases in the remaining 3 cases. The lymph node imaging was performed after the incision. The rate of lymph node fluorescence imaging was 92% (46/50). In the combined group, the total detection rate of sentinel lymph nodes (SLNs) was 98% (49/50). The number of SLNs was 180, of which 10 were positive (20.41%). The total detection rate of ICG was 90% (45/50), the number of detection was 158, positive in 8 cases (17.78%); methylene blue group the total detection rate was 88% (44/50), the number of detected 150, positive patients 7 cases (15.91%); the combined group of related indicators were better than ICG group and methylene blue group. CONCLUSION: Compared with single injection of ICG or methylene blue, ICG combined with methylene blue tracer method can significantly improve the detection rate and number of sentinel lymph nodes in patients with breast cancer, and provide more accurate guidance for the selection of surgical options in breast cancer patients.