单独使用亚甲蓝染料对乳腺癌患者进行前哨淋巴结活检：系统评价和荟萃分析。

Sentinel lymph node biopsy mapped with methylene blue dye alone in patients with breast cancer: A systematic review and meta-analysis.

机构信息

Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China.

Department of Neurology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong Province, China.

出版信息

PLoS One. 2018 Sep 20;13(9):e0204364. doi: 10.1371/journal.pone.0204364. eCollection 2018.

BACKGROUND

Methylene blue dye is easy to obtain in developing countries and can be used in sentinel lymph node mapping for breast cancer. However, the accuracy of methylene blue alone for sentinel lymph node mapping in breast cancer has not been well defined. In this study, we collected data to assess the feasibility and accuracy of sentinel lymph node biopsy mapped with methylene blue alone in patients with breast cancer.

METHODS

We searched the PubMed, EMBASE, and Cochrane Library databases from January 1, 1993, to March 31, 2018. Selected studies had to have a defined group of patients with breast cancer in which MBD alone was used as the mapping technique for SNB.

RESULTS

18 studies were included in this study. The combined identification rate was 91% [95% confidence interval (CI): 88%-94%, I2 = 68.3%], and the false negative rate was 13% (95% CI: 9%-18%, I2 = 36.7%). The pooled sensitivity, negative predictive value, and accuracy rate were 87% (95% CI: 82%-91%, I2 = 37.5%), 91% (95% CI: 87%-93%, I2 = 32.4%) and 94% (95% CI: 92%-96%, I2 = 29%), respectively.

CONCLUSIONS

This meta-analysis found that mapping sentinel lymph node locations with methylene blue dye alone results in an acceptable identification rate but an excessive false negative rate according to the American Society of Breast Surgeons' recommendations. Caution is warranted when using methylene blue dye alone as the mapping method for sentinel lymph node biopsy.

背景

亚甲蓝染料在发展中国家易于获得，可用于乳腺癌前哨淋巴结绘图。然而，单独使用亚甲蓝进行乳腺癌前哨淋巴结绘图的准确性尚未得到很好的定义。在本研究中，我们收集数据来评估单独使用亚甲蓝进行乳腺癌前哨淋巴结活检的可行性和准确性。

方法

我们从 1993 年 1 月 1 日至 2018 年 3 月 31 日检索了 PubMed、EMBASE 和 Cochrane Library 数据库。选择的研究必须有明确的一组乳腺癌患者，其中 MBD 单独用作 SNB 的绘图技术。

结果

本研究共纳入 18 项研究。联合检出率为 91%[95%置信区间（CI）：88%-94%，I²=68.3%]，假阴性率为 13%（95%CI：9%-18%，I²=36.7%）。合并敏感性、阴性预测值和准确率分别为 87%（95%CI：82%-91%，I²=37.5%）、91%（95%CI：87%-93%，I²=32.4%）和 94%（95%CI：92%-96%，I²=29%）。