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[荧光引导下乳腺癌前哨淋巴结活检:检出率与诊断准确性]

[Fluorescence-Guided Sentinel Lymph Node Biopsy in Breast Cancer: Detection Rate and Diagnostic Accuracy].

作者信息

Vaz Teresa, Costa Susy, Peleteiro Bárbara

机构信息

Faculdade de Medicina. Universidade do Porto. Porto. Portugal.

Departamento de Cirurgia. Centro Hospitalar de São João/Faculdade de Medicina. Universidade do Porto. Porto. Portugal.

出版信息

Acta Med Port. 2018 Dec 28;31(12):706-713. doi: 10.20344/amp.10395.

Abstract

INTRODUCTION

Sentinel lymph node biopsy is currently the standard surgical procedure for lymph node staging in patients with early stage breast cancer. It is performed using different techniques, such as the injection of vital dyes and / or radioisotopes and, more recently, guided by fluorescence using Indocyanine green. The aim of this study is to assess the detection rate of sentinel lymph node using Indocyanine green in breast cancer patients according to factors related to the patient and the tumor.

MATERIAL AND METHODS

Retrospective study of a random sample of patients with breast cancer, treated and followed at Centro Hospitalar São João, in Porto, between 2012 and 2016.

RESULTS

Indocyanine green detection rate was over 90% and its diagnostic accuracy was similar to other methods described in the presence of metastatic involvement of lymph nodes.

DISCUSSION

There was no statistically significant difference between the three methods in the detection rates in subgroups of older women, with normal weight and in those who underwent previous surgery in breast or axilla or neo-adjuvant chemotherapy.

CONCLUSION

Indocyanine green is a potential alternative method to other sentinel lymph node screening techniques, appearing as a future option for breast cancer centers with no nuclear medicine department. However, it is essential to carry out further research in order to define the ideal patients' profile that maximizes the method's effectiveness.

摘要

引言

前哨淋巴结活检目前是早期乳腺癌患者淋巴结分期的标准外科手术。其实施采用不同技术,如注射活性染料和/或放射性同位素,以及最近使用吲哚菁绿进行荧光引导。本研究的目的是根据与患者和肿瘤相关的因素,评估吲哚菁绿在乳腺癌患者中前哨淋巴结的检出率。

材料与方法

对2012年至2016年期间在波尔图圣若昂中心医院接受治疗和随访的乳腺癌患者随机样本进行回顾性研究。

结果

吲哚菁绿的检出率超过90%,在存在淋巴结转移的情况下,其诊断准确性与其他所述方法相似。

讨论

在老年女性亚组、体重正常以及曾接受过乳房或腋窝手术或新辅助化疗的患者中,三种方法的检出率无统计学显著差异。

结论

吲哚菁绿是其他前哨淋巴结筛查技术的一种潜在替代方法,对于没有核医学科的乳腺癌中心而言,它是一种未来选择。然而,有必要开展进一步研究以确定能使该方法效果最大化的理想患者特征。

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