Jung Minji, Jeon Jae Yong, Yun Gi Jeong, Yang Seoyon, Kwon Sara, Seo Yu Jin
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Medicine (Baltimore). 2018 Nov;97(44):e12945. doi: 10.1097/MD.0000000000012945.
Secondary lymphedema is a chronic debilitating lifelong complication and early diagnosis is crucial. The Inbody 720, which is widely used, has no universal index of diagnostic criteria for test results. We aim to determine the normal range, cutoff values, and mean + standard deviation values of extracellular fluid (ECF) and the single frequency bioimpedance (SFBIA) ratios for the diagnosis of lymphedema and suggest the usefulness of these values for detecting lymphedema.Seventy patients with unilateral breast cancer-related lymphedema and 643 healthy subjects were enrolled. All patients with breast cancer underwent surgeries with dissection of lymph nodes. We analyzed the ECF volume, SFBIA at 1- and 5-kHz frequencies using Inbody 720.There were significant differences between patients with BCRL and healthy controls. The optimal cutoff values for ECF ratios were 1.010 for both the dominant and non-dominant arms. At 1 kHz, the cutoff values of SFBIA were 1.050 and 1.046, and at 5 kHz, those were 1.070 and 1.030 for the dominant and non-dominant affected arms, respectively. The mean + 2SD values for ECF ratio were 1.018 and 1.020 and at 1 kHz, the mean + 2SD values of SFBIA were 1.144 and 1.0135 and at 5 kHz, the cutoff values of SFBIA were 1.141 and 1.124 for the dominant and non-dominant affected arms, respectively. The mean + 3SD values for ECF ratio were 1.026 and 1.030 and at 1 kHz, the mean + 3SD values of SFBIA were 1.206 and 1.203 and at 5 kHz, those were 1.201 and 1.187 for the arms, respectively. The cutoff, mean + 2SD, and mean + 3SD values were applied to 70 patients with unilateral BCRL. When the cutoff values were applied, a higher proportion of BCRL patients were included.When these figures were applied to the patient group, the cutoff values included a higher proportion of patients with lymphedema. Further studies are needed to investigate whether bioimpedance analysis can accurately predict the development of lymphedema.
继发性淋巴水肿是一种慢性、使人衰弱的终身并发症，早期诊断至关重要。广泛使用的Inbody 720对检测结果没有通用的诊断标准指标。我们旨在确定细胞外液（ECF）和单频生物电阻抗（SFBIA）比值的正常范围、临界值以及均值加标准差，用于淋巴水肿的诊断，并表明这些值在检测淋巴水肿方面的有用性。招募了70例单侧乳腺癌相关淋巴水肿患者和643名健康受试者。所有乳腺癌患者均接受了淋巴结清扫手术。我们使用Inbody 720分析了ECF体积、1kHz和5kHz频率下的SFBIA。乳腺癌相关淋巴水肿患者与健康对照者之间存在显著差异。优势侧和非优势侧手臂的ECF比值最佳临界值均为1.010。在1kHz时，优势侧和非优势侧受影响手臂的SFBIA临界值分别为1.050和1.046，在5kHz时，分别为1.070和1.030。ECF比值的均值加2标准差分别为1.018和1.020，在1kHz时，SFBIA的均值加2标准差分别为1.144和1.0135，在5kHz时，优势侧和非优势侧受影响手臂的SFBIA临界值分别为1.141和1.124。ECF比值的均值加3标准差分别为1.026和1.030，在1kHz时，SFBIA的均值加3标准差分别为1.206和1.203，在5kHz时，分别为1.201和1.187。将临界值、均值加2标准差和均值加3标准差应用于70例单侧乳腺癌相关淋巴水肿患者。应用临界值时，纳入的乳腺癌相关淋巴水肿患者比例更高。当将这些数值应用于患者组时，临界值纳入的淋巴水肿患者比例更高。需要进一步研究以调查生物电阻抗分析是否能够准确预测淋巴水肿的发展。
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