Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.
J Surg Oncol. 2011 Apr;103(5):421-5. doi: 10.1002/jso.21845. Epub 2010 Dec 28.
Sentinel lymph node biopsy (SNLB) is the standard of care in staging of melanoma and other skin cancers. Early studies used lymphazurin (LZ) for SLNB. A national shortage of LZ promoted methylene blue (MB) as an alternate stain.
This study compares complication rates between LZ and MB in SLNB patients, and the reliability dyes in locating sentinel lymph nodes.
Charts were reviewed for patients who underwent SLNB for skin cancers between September 2006 and November 2008 at Penn State Hershey Medical Center. The type and quantity of dye, the presence of blue stained sentinel nodes, and any complications were recorded.
Ninety-three patients underwent SLNB (46 LZ, 47 MB). The amount of dye used was similar (avg. 0.93 ml LZ, 1.24 ml MB). The complication rate of LZ was 8.7%, and MB was 25.5%. There was significantly more (P = 0.003) skin graft complications in the MB patients (6/12) versus LZ (0/15).
There is a higher rate of complications with MB, especially with skin grafting. The reported risk of anaphylaxis with LZ has not been reported in volumes <2 ml. The sentinel lymph node identification rate is historically similar between dyes, and in this study was noted to be higher with LZ.
前哨淋巴结活检（SNLB）是皮肤癌和其他皮肤癌分期的标准治疗方法。早期的研究使用淋巴紫（LZ）进行 SNLB。全国范围内 LZ 短缺促使亚甲蓝（MB）作为替代染料。
本研究比较了 SNLB 患者中 LZ 和 MB 的并发症发生率，以及定位前哨淋巴结的染料可靠性。
回顾了 2006 年 9 月至 2008 年 11 月期间在宾夕法尼亚州立大学赫尔希医疗中心接受皮肤癌 SNLB 的患者的图表。记录了染料的类型和数量、存在蓝色染色的前哨淋巴结以及任何并发症。
93 例患者接受了 SNLB（46 例 LZ，47 例 MB）。使用的染料量相似（平均 LZ 0.93ml，MB 1.24ml）。LZ 的并发症发生率为 8.7%，MB 为 25.5%。MB 患者（6/12）的皮肤移植物并发症明显多于 LZ 患者（0/15）（P=0.003）。
MB 的并发症发生率更高，特别是皮肤移植。据报道，LZ 的过敏反应风险在<2ml 体积内没有报道。在本研究中，两种染料的前哨淋巴结识别率均相似，并且 LZ 的识别率更高。
