Department of Surgery, School of Medicine, Cardiff University, Cardiff, UK.
Eur J Surg Oncol. 2010 Apr;36(4):399-403. doi: 10.1016/j.ejso.2009.10.007. Epub 2009 Nov 24.
Blue dye with or without isotope has been widely used to identify the sentinel lymph node(s) in breast cancer. Patent blue V is used in the UK while its isomer isosulfan blue is used in the US. The allergic potential of isosulfan blue is well documented (1.4% adverse reactions) but that of patent blue V is less clearly defined.
In this paper we review the adverse reactions of patent blue V in 7,917 patients who participated in the NEW START training programme and the ALMANAC trial. All patients underwent sentinel lymph node biopsy for breast carcinoma using patent blue V in combination with (99m)Tc-albumin colloid.
In total, 72 of 7,917 (0.9%) patients experienced adverse reactions : non-allergic reactions were observed in 4 (0.05%) patients, 23 (0.3%) patients had minor grade I allergic skin reactions (urticaria, blue hives, pruritus, or generalised rash) and 16 (0.2%) had grade II reactions (transient hypotension/bronchospasm/laryngospasm). Severe Grade III reactions (severe hypotension requiring vasopressor support and/or change/abandoning of planned procedure and/or HDU/ITU admission) were noted in 5 (0.06%) patients. The type of adverse reaction was not specified in 24 (0.3%) patients. No mortality was recorded.
The allergic potential of patent blue V dye compares favourably with isosulfan blue however both the surgeon and anaesthetist need to be alert to the risk of allergic reactions.
蓝色染料（无论是否带有同位素）已被广泛用于乳腺癌前哨淋巴结的识别。英国使用专利蓝 V，而美国则使用其异构体伊索夫兰蓝。伊索夫兰蓝的过敏潜在性已有充分记录（不良反应率为 1.4%），但专利蓝 V 的过敏潜在性则不太明确。
本文回顾了在参与 NEW START 培训计划和 ALMANAC 试验的 7917 例患者中，专利蓝 V 的不良反应。所有患者均接受了使用专利蓝 V 联合（99m）Tc-白蛋白胶体的前哨淋巴结活检。
共有 7917 例患者中的 72 例（0.9%）出现不良反应：4 例（0.05%）为非过敏反应，23 例（0.3%）患者出现轻微 1 级过敏皮肤反应（荨麻疹、蓝色风团、瘙痒或全身性皮疹），16 例（0.2%）患者出现 2 级反应（短暂性低血压/支气管痉挛/喉痉挛）。5 例（0.06%）患者出现严重 3 级反应（严重低血压需要血管加压支持和/或改变/放弃计划程序和/或 HDU/ITU 入院）。24 例（0.3%）患者的不良反应类型未具体说明。未记录到死亡。
专利蓝 V 染料的过敏潜在性与伊索夫兰蓝相比具有优势，但外科医生和麻醉师均需警惕过敏反应的风险。
