Fang L, Wang X Z, Liu Z Y, Li C, Yu Z Y
School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan 250200, China Department of Breast Surgery, Shandong Cancer Hospital and Institute, Jinan 250117, China Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China.
Department of Breast Surgery, Shandong Cancer Hospital and Institute, Jinan 250117, China Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China.
Zhonghua Zhong Liu Za Zhi. 2021 Feb 23;43(2):213-217. doi: 10.3760/cma.j.cn112152-20200602-00518.
To compare the application effect of blue dye single tracer and blue dye combined with nuclide double tracer in sentinel lymph node biopsy (SLNB) of breast cancer surgery. A total of 92 breast cancer patients in Shandong Cancer Hospital and Institute from November 2017 to October 2019 underwent methyleneblue dye combined with (99)Tc(m) sulfur colloid nuclide double tracer in SLNB, while other 92 cases in Jining First People Hospital underwent blue dye single tracer. The number of SLN detection, detection rate, accuracy rate, sensitivity, and false negative rate of the two groups were compared. The impacts of age, menstruation, tumor location, tumor size, clinical stage, pathological type, and estrogen receptor (ER), progesterone receptor (PR), human epidermal receptor 2 (HER-2), molecular typing, dynamic enhanced magnetic resonance imaging (DCE-MRI)on the detection rate of SLN were analyzed. The number of detection, detection rate, accuracy, sensitivity, and false negative rate of the blue dye single tracer group were 3.20±1.10, 90.22%, 93.48%, 95.24% and 4.76%, respectively; the double tracer group were 3.37±1.02, 92.39%, 95.65%, 95.65% and 4.35%, respectively, without significant difference (all >0.05). In different age, menstrual condition, tumor location, clinical stage, pathological type, ER, PR, HER-2 expression and molecular typing, the detection rate of single tracer group and double tracer group had no significant difference (all >0.05). However, in the tumor size of 2-5 cm and without DCE-MRI examination, the detection rate of single tracer group was significantly lower than that of double tracer group. The effect of blue dye single tracer in detecting SLN of breast cancer is equivalent to that of double tracer method, which is worthy of promotion and application in primary hospitals.
比较蓝色染料单示踪剂与蓝色染料联合核素双示踪剂在乳腺癌手术前哨淋巴结活检(SLNB)中的应用效果。2017年11月至2019年10月,山东省肿瘤医院和研究所的92例乳腺癌患者在SLNB中接受了亚甲蓝染料联合(99)Tc(m)硫胶体核素双示踪剂,而济宁市第一人民医院的其他92例患者接受了蓝色染料单示踪剂。比较两组前哨淋巴结(SLN)的检出数量、检出率、准确率、灵敏度和假阴性率。分析年龄、月经情况、肿瘤位置、肿瘤大小、临床分期、病理类型以及雌激素受体(ER)、孕激素受体(PR)、人表皮受体2(HER-2)、分子分型、动态增强磁共振成像(DCE-MRI)对SLN检出率的影响。蓝色染料单示踪剂组的检出数量、检出率、准确率、灵敏度和假阴性率分别为3.20±1.10、90.22%、93.48%、95.24%和4.76%;双示踪剂组分别为3.37±1.02、92.39%、95.65%、95.65%和4.35%,差异无统计学意义(均>0.05)。在不同年龄、月经状况、肿瘤位置、临床分期、病理类型、ER、PR、HER-2表达和分子分型中,单示踪剂组和双示踪剂组的检出率差异无统计学意义(均>0.05)。然而,在肿瘤大小为2-5 cm且未进行DCE-MRI检查时,单示踪剂组的检出率明显低于双示踪剂组。蓝色染料单示踪剂检测乳腺癌SLN的效果与双示踪剂法相当,值得在基层医院推广应用。