Department of Breast Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin Province, 130021 China.
Department of Hapatopancreatobiliary Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China.
Clin Breast Cancer. 2023 Jun;23(4):408-414. doi: 10.1016/j.clbc.2023.02.002. Epub 2023 Feb 11.
Currently, the standard tracing method is to use blue dyes and radioisotope as the tracer for sentinel lymph node biopsy (SLNB). However, there are variations in the choice of tracer in different countries and regions. Some new tracers are also gradually applied in clinical practice, but there is still a lack of long-term follow-up data to confirm their clinical application value.
Clinicopathological and postoperative treatment follow-up data were collected from patients with early-stage cTis-2N0M0 breast cancer who underwent SLNB using a dual-tracer method of ICG combined with MB. Statistical indicators including the identification rate, the number of sentinel lymph nodes (SLNs), regional lymph node recurrence, disease-free survival (DFS) and overall survival (OS) were analyzed.
Among the 1574 patients, SLNs were successfully detected during surgery in 1569 patients, with a detection rate of 99.7%; the median number of SLNs removed was 3. A total of 1531 patients were included in the survival analysis, with a median follow-up of 4.7 (0.5-7.9) years. In total, patients with positive SLNs had a 5-year DFS and OS of 90.6% and 94.7%, respectively. The 5-year DFS and OS of patients with negative SLNs were 95.6% and 97.3%, respectively. The postoperative regional lymph node recurrence rate was 0.7% in patients with negative SLNs.
Indocyanine green combined with methylene blue dual-tracer method is safe and effective in sentinel lymph node biopsy in patients with early breast cancer.
目前，标准的示踪方法是使用蓝染剂和放射性同位素作为前哨淋巴结活检（SLNB）的示踪剂。然而，不同国家和地区在示踪剂的选择上存在差异。一些新的示踪剂也逐渐应用于临床实践，但仍缺乏长期随访数据来确认其临床应用价值。
收集采用 ICG 联合 MB 双示踪剂法行 SLNB 的 cTis-2N0M0 期早期乳腺癌患者的临床病理和术后治疗随访资料，分析包括识别率、前哨淋巴结（SLN）数量、区域淋巴结复发、无病生存（DFS）和总生存（OS）等统计指标。
在 1574 例患者中，1569 例患者在手术中成功检测到 SLN，检测率为 99.7%；切除的 SLN 中位数为 3 枚。共纳入 1531 例患者进行生存分析，中位随访时间为 4.7（0.5-7.9）年。总的来说，有阳性 SLN 的患者 5 年 DFS 和 OS 分别为 90.6%和 94.7%，而阴性 SLN 的患者 5 年 DFS 和 OS 分别为 95.6%和 97.3%。阴性 SLN 的患者术后区域淋巴结复发率为 0.7%。
吲哚菁绿联合亚甲蓝双示踪剂法在早期乳腺癌患者的 SLNB 中安全有效。
