■许多乳腺癌患者在前哨淋巴结活检(SLNB)后避免了腋窝淋巴结清扫。在SLNB操作期间,淋巴管的颜色有时很差,所以很难找到它们。这项研究观察了三种示踪剂组合的示踪效果,并报告了我们简化SLNB程序的经验。
■总共,回顾性研究了123例TNM分期为cT1-2N0M0的乳腺癌患者。根据使用的示踪剂,将患者分为纳米碳(CNP)组(38例),CNP联合亚甲蓝(CNP+MB)组41例,吲哚菁绿结合MB(ICG+MB)组44例。所有123例乳腺癌病例也根据SLNB手术流程分为非追踪组(53例)和追踪组(70例)。非追踪组直接寻找染色的前哨淋巴结,而追踪组沿着淋巴管寻找染色的淋巴结。
■CNP中的SLN识别率,CNP+MB,ICG+MB组为97.4%,97.6%,分别为95.5%(P>0.05)。SLN的平均检出数分别为4.92±2.06、5.12±2.18、4.57±1.90(P>0.05)。三组淋巴管的理想显示率为86.8%,87.8%,和93.2%,分别为(P>0.05)。非跟踪组和跟踪组的SLN识别率分别为96.2%和97.1%,分别为(P>0.05)。平均检测到的SLN数分别为5.73±1.76和5.70±1.93(P>0.05),平均手术时间为16.47±5.78和27.53±7.75min,分别为(P<0.05)。
■这是第一个观察CNP联合MB和ICG联合MB示踪剂在乳腺癌患者SLNB中的应用效果的研究。在SLN识别和淋巴管显示方面,患者之间没有显着差异。在SLNB手术中省略寻找淋巴管的步骤并不会降低手术效果,但是减少手术步骤可以减少手术时间,理论上可以减少术后并发症。
UNASSIGNED: Many breast cancer patients have avoided axillary lymph node dissection after sentinel lymph node biopsy (SLNB). During the SLNB operation, the color of lymphatic vessels is sometimes poor and so finding them is difficult. This study observed the tracing effects of three
tracer combinations and also reported our experience in simplifying the SLNB program.
UNASSIGNED: In total, 123 breast cancer patients whose TNM stage was cT1-2N0M0 were retrospectively studied. According to the
tracer used, the patients were divided into the carbon nanoparticle (CNP) group (38 cases), CNP combined with methylene blue (CNP + MB) group (41 cases), and indocyanine green combined with MB (ICG + MB) group (44 cases). All 123 breast cancer cases were also classified into the non-tracking group (53 cases) and tracking group (70 cases) according to the SLNB operation process. The non-tracking group looked for the stained sentinel lymph nodes directly, while the tracking group looked for the stained lymph nodes along the lymphatic vessels.
UNASSIGNED: The SLN identification rates in the CNP, CNP + MB, and ICG + MB groups were 97.4%, 97.6%, and 95.5% respectively (P > 0.05). The average number of SLNs detected was 4.92 ± 2.06, 5.12 ± 2.18, and 4.57 ± 1.90, respectively (P > 0.05). The ideal display rates of lymphatic vessels in the three groups were 86.8%, 87.8%, and 93.2%, respectively (P > 0.05). The SLN identification rates in the non-tracking and tracking groups were 96.2% and 97.1%, respectively (P > 0.05). The average number of SLNs detected were 5.73 ± 1.76 and 5.70 ± 1.93, respectively (P > 0.05), and the average operation time was 16.47 ± 5.78 and 27.53 ± 7.75 min, respectively (P < 0.05).
UNASSIGNED: This is the first study to observe the application effect of CNP combined with MB and ICG combined with MB tracers in SLNB of breast cancer patients. No significant difference was observed among the patients in SLN identification and lymphatic vessel display. Omitting the step of searching for lymphatic vessels in SLNB surgery does not reduce the surgical effect, but the reduced operating steps can reduce the surgical time and theoretically reduce postoperative complications.