Ji Yinan, Luo Ningbin, Jiang Yi, Li Qiuyun, Wei Wei, Yang Huawei, Liu Jianlun
Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China.
Department of Radiology, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China.
J Surg Res. 2017 Jul;215:88-92. doi: 10.1016/j.jss.2017.03.038. Epub 2017 Apr 1.
Indocyanine green (ICG) is widely used as a tracer in sentinel lymph node biopsy (SLNB) of patients with breast cancer. Whether SLNB performance can be improved by supplementing ICG with methylene blue dye remains controversial. This study compared the performance of SLNB when ICG was used alone or with blue dye.
Consecutive patients with T1-3 primary breast cancer at our hospital were recruited into our study and randomized to undergo SLNB with ICG alone (n = 62) or with the combination of ICG and blue dye (n = 65). We compared the two methods in terms of identification rate, number and detection time of sentinel lymph nodes (SLNs) removed.
SLN identification rate were similar in the absence (95.2%) or presence of blue dye (98.5%, P = 0.578) but significantly, more average nodes were removed when blue dye was used (3.8 ± 1.5 versus 2.7 ± 1.2, P = 0.000), and the average time for detecting each SLN was significantly shorter (3.91 ± 1.87 versus 5.65 ± 2.95 min; P = 0.000). No patient in the study experienced severe adverse reactions or complications. Recurrence of axillary node was detected in one patient (1.6%) using ICG alone but not in any patients using ICG and blue dye.
The efficiency and sensitivity of SLNB can be improved by combining ICG with blue dye.
吲哚菁绿（ICG）在乳腺癌患者前哨淋巴结活检（SLNB）中被广泛用作示踪剂。补充亚甲蓝染料是否能提高前哨淋巴结活检的性能仍存在争议。本研究比较了单独使用ICG或与蓝色染料联合使用时前哨淋巴结活检的性能。
连续纳入我院T1-3期原发性乳腺癌患者，随机分为单独使用ICG进行前哨淋巴结活检组（n = 62）或ICG与蓝色染料联合使用组（n = 65）。我们比较了两种方法在前哨淋巴结（SLN）的识别率、切除的前哨淋巴结数量和检测时间方面的差异。
在不使用蓝色染料（95.2%）或使用蓝色染料（98.5%，P = 0.578）的情况下，前哨淋巴结识别率相似，但使用蓝色染料时平均切除的淋巴结数量显著更多（3.8 ± 1.5对2.7 ± 1.2，P = 0.000），并且检测每个前哨淋巴结的平均时间显著更短（3.91 ± 1.87对5.65 ± 2.95分钟；P = 0.000）。本研究中没有患者出现严重不良反应或并发症。单独使用ICG的一名患者（1.6%）检测到腋窝淋巴结复发，而使用ICG和蓝色染料的患者均未出现复发。
将ICG与蓝色染料联合使用可提高前哨淋巴结活检的效率和敏感性。
