Department of Surgical Oncology, M. D. Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Ann Surg Oncol. 2010 Oct;17 Suppl 3(0 3):280-5. doi: 10.1245/s10434-010-1235-5. Epub 2010 Sep 19.
We sought to evaluate the utilization of blue dye in addition to radioisotope and its relative contribution to sentinel lymph node (SLN) mapping at a high-volume institution.
Using a prospectively maintained database, 3,402 breast cancer patients undergoing SLN mapping between 2002 and 2006 were identified. Trends in utilization of blue dye and results of SLN mapping were assessed through retrospective review. Statistical analysis was performed with Student t test and chi-square analysis.
2,049 (60.2%) patients underwent mapping with dual technique, and 1,353 (39.8%) with radioisotope only. Blue dye use decreased gradually over time (69.8% in 2002 to 48.3% in 2006, p < 0.0001). Blue dye was used significantly more frequently in patients with lower axillary counts, higher body mass index (BMI), African-American race, and higher T stage, and in patients not undergoing skin-sparing mastectomy. There was no difference in SLN identification rates between patients who had dual technique versus radiocolloid alone (both 98.4%). Four (0.8%) of 496 patients who had dual mapping and a positive SLN had a blue but not hot node as the only involved SLN. None of these four had significant counts detected in the axilla intraoperatively. Nine (0.4%) of 2,049 patients who had dual mapping had allergic reactions attributed to blue dye.
Blue dye use has decreased with increasing institutional experience with SLN mapping. In patients with adequate radioactive counts in the axilla, blue dye is unlikely to improve the success of sentinel node mapping.
我们旨在评估在高容量机构中，除放射性同位素外，蓝色染料的使用及其对前哨淋巴结 (SLN) 绘图的相对贡献。
使用前瞻性维护的数据库，确定了 2002 年至 2006 年间接受 SLN 绘图的 3402 例乳腺癌患者。通过回顾性审查评估蓝色染料的使用趋势和 SLN 绘图的结果。统计分析采用学生 t 检验和卡方分析。
2049 例 (60.2%)患者采用双技术进行绘图，1353 例 (39.8%)仅采用放射性同位素。蓝色染料的使用随着时间的推移逐渐减少（2002 年为 69.8%，2006 年为 48.3%，p < 0.0001）。蓝色染料在腋窝计数较低、身体质量指数（BMI）较高、非裔美国人种族、T 期较高、未行皮肤保留乳房切除术的患者中使用更为频繁。采用双技术与单独使用放射性胶体的 SLN 识别率无差异（均为 98.4%）。在 496 例双绘图且 SLN 阳性的患者中，有 4 例（0.8%）仅有蓝色但无热点作为唯一受累的 SLN。这些患者中没有术中在腋窝中检测到明显的计数。在 2049 例双绘图患者中，有 9 例（0.4%）出现过敏反应归因于蓝色染料。
随着 SLN 绘图机构经验的增加，蓝色染料的使用有所减少。在腋窝放射性计数足够的患者中，蓝色染料不太可能提高前哨淋巴结绘图的成功率。
