Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia.
Department of Surgery, Oncology Division, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia.
Asian Pac J Cancer Prev. 2020 Jun 1;21(6):1767-1771. doi: 10.31557/APJCP.2020.21.6.1767.
Chemotherapy is claimed to cause lymphatic drainage damage because of the tumor cell's apoptosis process. This event might cause decreased marker (radioactive solution and/or blue dye) absorption on sentinel lymph nodes (SLN). In this study, the researchers used methylene blue only and wished to evaluate the methylene blue absorption of the SLNB procedure on early-stage breast-cancer patients after neoadjuvant chemotherapy (NAC).
The method used was the historical cohort study conducted from 2016-2019 in Indonesia. Samples were collected from 117 patients of stage I and II breast cancer with clinically negative axillary lymph nodes, who were then grouped into post-NAC and no-NAC (control group), in which SLNB procedures were conducted on the two groups by using single-method methylene blue. The results of methylene blue absorption were then analyzed by the Chi-square hypothesis test.
From the total of 564 early-stage patients who were referred to surgical oncologists, 117 patients were found to meet criteria of inclusion, consisting of the control group (52 patients) and the post-NAC group (65 patents). Of 65 patients who had undergone NAC treatment and SLNB procedure, it was found that 40 patients (61.5%) showed positive blue SLN. Of 52 pre-NAC breast-cancer patients, it was found that 47 patients (90.4%) showed methylene blue absorption on SLN with the p-value of 0.000 (P<0.05, significant). The relative risk value amounted to 0.522. Post-NAC patients had a tendency of decreased absorption of methylene blue.
Neoadjuvant chemotherapy can cause the decrease of methylene blue absorption on SLNB procedure.
化疗据称会导致淋巴管引流损伤，这是由于肿瘤细胞的凋亡过程。这一事件可能导致前哨淋巴结 (SLN) 上标记物（放射性溶液和/或蓝色染料）吸收减少。在这项研究中，研究人员仅使用亚甲蓝，并希望评估新辅助化疗 (NAC) 后早期乳腺癌患者 SLNB 中亚甲蓝的吸收。
该方法是 2016-2019 年在印度尼西亚进行的历史队列研究。从 117 名临床腋窝淋巴结阴性的 I 期和 II 期乳腺癌患者中采集样本，然后将其分为 NAC 后组和无 NAC（对照组），两组均采用单方法亚甲蓝进行 SLNB 手术。然后通过卡方假设检验分析亚甲蓝吸收的结果。
从总共被转介给外科肿瘤医生的 564 名早期患者中，发现 117 名患者符合纳入标准，包括对照组（52 名患者）和 NAC 后组（65 名患者）。在接受 NAC 治疗和 SLNB 手术的 65 名患者中，发现 40 名患者（61.5%）的蓝色 SLN 呈阳性。在 52 名 NAC 前乳腺癌患者中，发现 47 名患者（90.4%）的 SLN 吸收了亚甲蓝，p 值为 0.000（P<0.05，具有统计学意义）。相对风险值为 0.522。NAC 后患者的亚甲蓝吸收呈下降趋势。
新辅助化疗可导致 SLNB 中亚甲蓝吸收减少。
