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早期乳腺癌前哨淋巴结定位：荧光素引导下全印度医学科学研究所阿努拉格技术与锝-99m硫胶体加亚甲蓝的随机对照比较

Sentinel Node Mapping in Early Breast Cancer: A Randomized Comparison of Fluorescein Guided All India Institute of Medical Sciences, Anurag's Technique with Technetium-99 m Sulfur Colloid Plus Methylene Blue.

作者信息

Khadka Sarada, Suresh Jayesh, Prem Amar, Mishra Piyush Ranjan, Kataria Kamal, Dhar Anita, Seenu Vuthaluru, Bal Chandershekhar, Kumar Rakesh, Mathur Sandeep, Hari Smriti, Pandey Ravindra Mohan, Srivastava Anurag

机构信息

Department of Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal.

Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Nucl Med. 2022 Jul-Sep;37(3):236-244. doi: 10.4103/ijnm.ijnm_3_22. Epub 2022 Nov 2.

DOI:10.4103/ijnm.ijnm_3_22
PMID:36686308
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9855248/
Abstract

PURPOSE

Evaluation of fluorescein along with blue dye as an affordable tracer for sentinel node biopsy in comparison with technetium + methylene blue. A randomized trial was conducted with the following objectives: (1) to demonstrate that the identification of sentinel lymph node by fluorescein + methylene blue is not inferior to the identification by Tc-99 m sulfur colloid + methylene blue and (2) to evaluate the cost-effectiveness of sentinel node biopsy by above two tracers.

SUBJECTS AND METHODS

One-thirty patients above age 18 years presenting with early breast cancer T1, T2, N0 breast carcinoma were randomized to undergo sentinel node biopsy by either fluorescein + methylene blue or Tc-99 m sulfur colloid + methylene blue.

RESULTS

The sentinel lymph nodes were identified in 89% in Fluorescein + methylene blue group and 90.9% with Tc-99 m sulfur colloid + methylene blue group. The trial demonstrated noninferiority of fluorescein + methylene blue as compared to isotope + methylene blue with effect size = 1; 95% confidence interval- 9.54 to + 11.54. The fluorescein + methylene blue was more cost-effective than isotope guided sentinel node biopsy.

CONCLUSION

Fluorescein-guided sentinel node biopsy is noninferior and more cost-effective than isotope-guided sentinel node biopsy.

摘要

目的

评估荧光素与蓝色染料作为前哨淋巴结活检的一种经济实惠的示踪剂，并与锝+亚甲蓝进行比较。进行了一项随机试验，其目标如下：（1）证明荧光素+亚甲蓝识别前哨淋巴结的效果不劣于锝-99m硫胶体+亚甲蓝，（2）评估上述两种示踪剂在前哨淋巴结活检中的成本效益。

受试者与方法

130例年龄在18岁以上的早期乳腺癌T1、T2、N0期乳腺癌患者被随机分为两组，分别接受荧光素+亚甲蓝或锝-99m硫胶体+亚甲蓝的前哨淋巴结活检。

结果

荧光素+亚甲蓝组前哨淋巴结识别率为89%，锝-99m硫胶体+亚甲蓝组为90.9%。该试验证明，与同位素+亚甲蓝相比，荧光素+亚甲蓝并不逊色，效应大小=1；95%置信区间为-9.54至+11.54。荧光素+亚甲蓝比同位素引导的前哨淋巴结活检更具成本效益。

结论

荧光素引导的前哨淋巴结活检不劣于同位素引导的前哨淋巴结活检，且成本效益更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/d5e942f9c333/IJNM-37-236-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/c161fcc3f331/IJNM-37-236-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/96dab83c135b/IJNM-37-236-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/5f663498ca68/IJNM-37-236-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/3c827b410d08/IJNM-37-236-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/7727c65ee159/IJNM-37-236-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/6093a19f6d4b/IJNM-37-236-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/d5e942f9c333/IJNM-37-236-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/c161fcc3f331/IJNM-37-236-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/96dab83c135b/IJNM-37-236-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/5f663498ca68/IJNM-37-236-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/3c827b410d08/IJNM-37-236-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/7727c65ee159/IJNM-37-236-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/6093a19f6d4b/IJNM-37-236-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/002b/9855248/d5e942f9c333/IJNM-37-236-g007.jpg

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Sci Rep. 2021 Jun 9;11(1):12119. doi: 10.1038/s41598-021-91641-1.
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Low-cost Fluorescein as an Alternative to Radio-colloid for Sentinel Lymph Node Biopsy-a Prospective Validation Study in Early Breast Cancer.低成本荧光素作为前哨淋巴结活检中放射性胶体的替代物——早期乳腺癌的前瞻性验证研究。
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