Liu Jun, Huang Linping, Wang Ning, Chen Ping
Breast Cancer Centre, China-Japan Friendship Hospital, Beijing, China.
J Int Med Res. 2017 Apr;45(2):514-524. doi: 10.1177/0300060516687149. Epub 2017 Jan 1.
Objective To explore the clinical value of indocyanine green (ICG) for the fluorescence-guided detection of sentinel lymph nodes (SLNs) during sentinel lymph node biopsy (SLNB) in patients with early breast cancer. Methods This retrospective study included female patients with breast cancer. Patients were administered methylene blue and ICG using standard techniques. All SLNs that were collected during surgery were submitted for pathological examination. SLNs were defined as those that were either fluorescent, blue, fluorescent and blue or palpably suspicious. Surgical complications, axillary recurrence, distant metastasis and overall survival rates were observed postoperatively. Results A total of 60 patients were enrolled in the study. The fluorescence detection rate of SLNs was 100% ( n = 177), with a mean of 2.95 SLNs per patient. The methylene blue staining rate was 88.3% ( n = 106), with a mean of 1.77 SLNs per patient. Pathological assessment of intraoperative frozen specimens revealed SLN metastases in 10 patients, who immediately underwent axillary lymph node dissection. No patient had axillary recurrence or distant metastases, with a survival rate of 100%. Patients who underwent SLNB showed good appearance in the axillary wound, with no limited shoulder joint abduction and upper limb oedema. Conclusion Fluorescence-guided SLNB has several advantages and is suitable for clinical application.
目的 探讨吲哚菁绿（ICG）在早期乳腺癌患者前哨淋巴结活检（SLNB）中用于荧光引导检测前哨淋巴结（SLN）的临床价值。方法 本回顾性研究纳入了乳腺癌女性患者。采用标准技术给患者注射亚甲蓝和ICG。手术中采集的所有SLN均进行病理检查。SLN定义为荧光阳性、蓝色、荧光和蓝色均阳性或可触及可疑的淋巴结。术后观察手术并发症、腋窝复发、远处转移和总生存率。结果 共纳入60例患者。SLN的荧光检出率为100%（n = 177），平均每位患者有2.95个SLN。亚甲蓝染色率为88.3%（n = 106），平均每位患者有1.77个SLN。术中冰冻标本的病理评估显示10例患者有SLN转移，这些患者立即接受了腋窝淋巴结清扫。无患者出现腋窝复发或远处转移，生存率为100%。接受SLNB的患者腋窝伤口外观良好，肩关节外展无受限，上肢无水肿。结论 荧光引导下的SLNB有诸多优点，适合临床应用。
