超声引导下 Hookwire 定位前哨淋巴结活检联合一步法核酸扩增检测在乳腺癌中的应用

Hookwire-guided Sentinel Lymph Node Biopsy Using Contrast-enhanced Ultrasonography Followed by a One-step Nucleic Acid Amplification (OSNA) Assay for Breast Cancer.

机构信息

Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

出版信息

Anticancer Res. 2019 Nov;39(11):6183-6192. doi: 10.21873/anticanres.13826.

DOI:10.21873/anticanres.13826

PMID:31704846

Abstract

AIM

To investigate the feasibility of hookwire-guided sentinel lymph node biopsy (SLNB) using contrast-enhanced ultrasonography (CEUS) followed by a one-step nucleic acid amplification (OSNA) assay.

PATIENTS AND METHODS

Clinical T1-2N0M0 breast cancer patients scheduled to undergo SLNB participated in this study. Both Sonazoid® and dye were used as tracers, and the most upstream sentinel lymph node (SLN) at each lymphatic flow detected by CEUS (First-SLN) was sampled under hookwire guidance, a procedure called "Sona-Hook".

RESULTS

In each of the 50 cases, at least one First-SLN was extracted by "Sona-Hook". All contrast-enhanced SLNs (CE-SLNs) were dye-positive, and the mean number of CE-SLNs sampled per patient was lower than that of dye-positive SLNs (1.48 vs. 1.88, p<0.01). Through OSNA, qualitative assessment of tumor metastasis between First-SLNs and all SLNs completely matched together.

CONCLUSION

"Sona-Hook" for First-SLN followed by an OSNA assay may be a feasible minimally invasive SLNB strategy.

摘要

目的

探讨超声造影（CEUS）引导下使用钩丝活检（SLNB）联合一步法核酸扩增（OSNA）检测前哨淋巴结（SLN）的可行性。

患者与方法

本研究纳入了临床 T1-2N0M0 期乳腺癌患者，使用 SonoVue®和染料作为示踪剂，CEUS 检测到的最上游淋巴管中首先出现增强的 SLN（First-SLN），通过钩丝引导下进行取样，称为“Sona-Hook”。

结果

在 50 例患者中，均至少通过“Sona-Hook”取出了一个 First-SLN。所有增强的 SLN（CE-SLNs）均为染料阳性，每位患者取样的 CE-SLNs 数量均少于染料阳性的 SLNs（1.48 比 1.88，p<0.01）。通过 OSNA，对 First-SLN 和所有 SLNs 的肿瘤转移进行定性评估，结果完全一致。