Srivastava Anurag, Goyal Amit, Seenu Vuthaluru, Kumar Rakesh
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Department of Breast Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom.
Indian J Nucl Med. 2023 Jan-Mar;38(1):91-95. doi: 10.4103/ijnm.ijnm_38_22. Epub 2023 Feb 24.
Sentinel node mapping is the standard of care for evaluation of axilla for women with early node negative breast cancer. Validation of a new tracer for sentinel node biopsy requires full axillary lymph node dissection to establish its performance indicators. This exposes about 70% of women to unnecessary axillary dissection with its attendant morbidity.
To investigate the predictive value of identification of sentinel lymph nodes by a tracer for knowing its sensitivity and false-negative rates (FNR).
A linear regression on data from a network meta-analysis was carried out, and the correlation between identification and sensitivity and its predictive value were ascertained.
A strong linear relationship was observed between identification and sensitivity of sentinel node biopsy (correlation coefficient = 0.97). The sensitivity and false negativity can be predicted by the identification rate. An identification rate of 93% corresponds to sensitivity = 90.51% and a FNR = 9.49%. The current literature on newer tracers has been succinctly reviewed.
The linear regression demonstrated a very high predictive value of identification rate for ascertaining the sensitivity and FNRs of sentinel node biopsy. A new tracer for sentinel node biopsy can be introduced in clinical practice, if it achieves an identification rate of 93% or more.
前哨淋巴结定位是早期淋巴结阴性乳腺癌女性腋窝评估的标准治疗方法。验证一种用于前哨淋巴结活检的新型示踪剂需要进行全腋窝淋巴结清扫以确定其性能指标。这会使约70%的女性接受不必要的腋窝清扫及其伴随的发病率。
研究通过示踪剂识别前哨淋巴结对于了解其敏感性和假阴性率（FNR）的预测价值。
对来自网络荟萃分析的数据进行线性回归，并确定识别与敏感性之间的相关性及其预测价值。
在前哨淋巴结活检的识别与敏感性之间观察到强线性关系（相关系数 = 0.97）。敏感性和假阴性可通过识别率预测。识别率为93%时对应敏感性 = 90.51%，FNR = 9.49%。对有关新型示踪剂的当前文献进行了简要综述。
线性回归表明识别率对于确定前哨淋巴结活检的敏感性和FNR具有非常高的预测价值。如果一种用于前哨淋巴结活检的新型示踪剂达到93%或更高的识别率，就可以引入临床实践。
