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本文引用的文献

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Bioimpedance Spectroscopy for Breast Cancer Related Lymphedema Assessment: Clinical Practice Guidelines.用于乳腺癌相关淋巴水肿评估的生物电阻抗光谱法:临床实践指南
Breast J. 2016 Nov;22(6):645-650. doi: 10.1111/tbj.12647. Epub 2016 Aug 4.
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Diagnosis of upper limb lymphedema: development of an evidence-based approach.上肢淋巴水肿的诊断:循证方法的发展
Acta Oncol. 2016 Dec;55(12):1477-1483. doi: 10.1080/0284186X.2016.1191668. Epub 2016 Jun 22.
3
Experimental and Analytical Comparisons of Tissue Dielectric Constant (TDC) and Bioimpedance Spectroscopy (BIS) in Assessment of Early Arm Lymphedema in Breast Cancer Patients after Axillary Surgery and Radiotherapy.组织介电常数(TDC)与生物电阻抗光谱(BIS)在评估乳腺癌患者腋窝手术及放疗后早期上肢淋巴水肿中的实验与分析比较
Lymphat Res Biol. 2015 Sep;13(3):176-85. doi: 10.1089/lrb.2015.0019. Epub 2015 Aug 25.
4
The importance of detection of subclinical lymphedema for the prevention of breast cancer-related clinical lymphedema after axillary lymph node dissection; a prospective observational study.腋窝淋巴结清扫术后亚临床淋巴水肿的检测对预防乳腺癌相关临床淋巴水肿的重要性:一项前瞻性观察研究。
Lymphat Res Biol. 2014 Dec;12(4):289-94. doi: 10.1089/lrb.2014.0035.
5
L-dex ratio in detecting breast cancer-related lymphedema: reliability, sensitivity, and specificity.L-dex 比值在检测乳腺癌相关淋巴水肿中的可靠性、敏感性和特异性。
Lymphology. 2013 Jun;46(2):85-96.
6
Confirmation of the reference impedance ratios used for assessment of breast cancer-related lymphedema by bioelectrical impedance spectroscopy.通过生物电阻抗光谱法确认用于评估乳腺癌相关淋巴水肿的参考阻抗比。
Lymphat Res Biol. 2011 Mar;9(1):47-51. doi: 10.1089/lrb.2010.0014.
7
Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial.早期物理治疗预防乳腺癌手术后淋巴水肿的效果:随机、单盲、临床试验。
BMJ. 2010 Jan 12;340:b5396. doi: 10.1136/bmj.b5396.
8
Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment.淋巴水肿:肿瘤治疗中慢性疾病识别与管理入门
CA Cancer J Clin. 2009 Jan-Feb;59(1):8-24. doi: 10.3322/caac.20001.
9
Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function.乳腺癌后的淋巴水肿:发病率、危险因素及对上身功能的影响。
J Clin Oncol. 2008 Jul 20;26(21):3536-42. doi: 10.1200/JCO.2007.14.4899.
10
Preoperative assessment enables the early diagnosis and successful treatment of lymphedema.术前评估有助于淋巴水肿的早期诊断和成功治疗。
Cancer. 2008 Jun 15;112(12):2809-19. doi: 10.1002/cncr.23494.

一项关于乳腺癌患者术前及术后12个月L-Dex值的前瞻性研究。

A Prospective Study of L-Dex Values in Breast Cancer Patients Pretreatment and Through 12 Months Postoperatively.

作者信息

Ridner Sheila H, Dietrich Mary S, Spotanski Kandace, Doersam Jennifer K, Cowher Michael S, Taback Bret, McLaughlin Sarah, Ajkay Nicolas, Boyages John, Koelmeyer Louise, DeSnyder Sarah, Shah Chirag, Vicini Frank

机构信息

1 School of Nursing, Vanderbilt University , Nashville, Tennessee.

2 Department of Biostatistics, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center , Nashville, Tennessee.

出版信息

Lymphat Res Biol. 2018 Oct;16(5):435-441. doi: 10.1089/lrb.2017.0070. Epub 2018 Aug 21.

DOI:10.1089/lrb.2017.0070
PMID:30130147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6913109/
Abstract

BACKGROUND

Data regarding pretreatment, bioimpedance spectroscopy (BIS) L-Dex values for patients newly diagnosed with breast cancer, and longitudinal data 12 months postoperatively are lacking. This study describes L-Dex values at the time of breast cancer diagnosis and maximum L-Dex change within 12 months of surgery.

METHODS AND RESULTS

Patients were enrolled in a parent, clinical trial that compares the effectiveness of BIS for early detection of breast cancer-related lymphedema to tape measurement. A total of 280 women with a pretreatment and at least one postoperative L-Dex measurement (within 12 months of surgery) were included. Pretreatment L-Dex readings were compared with population norms and maximum L-Dex changes within 12 months were examined. An L-Dex U400 device was used to obtain BIS measurements. The documented normative mean value using this device is 0.00, which is at the 49th percentile for this sample. Approximately 6% of patients had a pretreatment L-Dex value of ≥7.0; 1.8% had an L-Dex value ≥10.0. For 12 months, 17.1% (n = 48) of patients had a maximum change in L-Dex value from pretreatment of ≥7.0 L-Dex units, suggestive of clinical lymphedema.

CONCLUSIONS

At the time of breast cancer diagnosis, L-Dex values are similar to normative values. Identified maximum changes in L-Dex values 12 months postoperatively suggest that frequent L-Dex measurements during that time frame are of potential clinical benefit. Our findings are consistent with research supporting an L-Dex value of ≥7 as indicative of clinical lymphedema with subclinical lymphedema logically occurring at somewhat lower likely, near ≥6.5.

摘要

背景

缺乏关于新诊断乳腺癌患者的预处理生物电阻抗光谱(BIS)L-Dex值以及术后12个月纵向数据的相关资料。本研究描述了乳腺癌诊断时的L-Dex值以及手术12个月内L-Dex的最大变化。

方法与结果

患者参与了一项母体临床试验,该试验比较了BIS与卷尺测量法在早期检测乳腺癌相关淋巴水肿方面的有效性。总共纳入了280名有预处理及至少一次术后L-Dex测量值(手术12个月内)的女性。将预处理L-Dex读数与总体标准值进行比较,并检查手术12个月内L-Dex的最大变化。使用L-Dex U400设备获取BIS测量值。使用该设备记录的标准平均值为0.00,在本样本中处于第49百分位数。约6%的患者预处理L-Dex值≥7.0;1.8%的患者L-Dex值≥10.0。在12个月内,17.1%(n = 48)的患者L-Dex值相对于预处理的最大变化≥7.0 L-Dex单位,提示临床淋巴水肿。

结论

在乳腺癌诊断时,L-Dex值与标准值相似。术后12个月L-Dex值的最大变化表明,在此时间段内频繁进行L-Dex测量具有潜在的临床益处。我们的研究结果与支持L-Dex值≥7表示临床淋巴水肿的研究一致,亚临床淋巴水肿可能在略低水平(接近≥6.5)时出现。