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使用Magtrace作为早期乳腺癌腋窝分期的替代方法:单中心经验

Use of Magtrace as an Alternative Approach in Staging the Axilla in Early-Stage Breast Cancer: A Single-Center Experience.

作者信息

Oweis Rami, Anil Aditya, Marinov Alexander, Hamati Tawfiq, Masudi Tahir

机构信息

Department of Breast Surgery, The Rotherham NHS Foundation Trust, Rotherham, GBR.

School of Medicine and Population Health, The University of Sheffield, Sheffield, GBR.

出版信息

Cureus. 2024 Dec 3;16(12):e75015. doi: 10.7759/cureus.75015. eCollection 2024 Dec.

DOI:10.7759/cureus.75015
PMID:39759618
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11698378/
Abstract

Background The sentinel lymph node biopsy (SLNB) is the standard method used to determine the stage of breast cancer in patients with no clinical signs of axillary involvement. The current gold standard for the intraoperative assessment of the axilla involves the use of dual radioisotope and patent blue dye. However, researchers have been studying the use of superparamagnetic iron oxide Magtrace® (Endomagnetics Limited, Cambridge, United Kingdom) agents as an alternative to overcome the limitations of the standard SLNB technique. Aim The objective of this study was to assess the potential equivalency of the new SentiMag® (Endomagnetics Limited, Cambridge, United Kingdom) technique compared to the gold standard. The primary endpoints included the detection rate per patient and the number of lymph nodes retrieved. Materials and methods A single-center retrospective study was done in the Rotherham NHS Foundation Trust, UK, for patients who underwent SLNB from October 2021 to January 2022. Sixty patients were randomly selected and assigned into two arms: Magtrace and technetium-99m (99mTc). Categorical variables were compared using Fisher's exact test. Student's t-test was performed to compare continuous variables. Results There was a higher incidence of axillary seroma observed in the group of patients who underwent the Magtrace procedure. The average duration of the surgical procedure was longer for patients in the Magtrace arm compared to those in the 99mTc arm. The detection rate of SLNB was higher in the group of patients who received 99mTc. Both groups had a similar number of lymph nodes retrieved during the procedure. The length of hospital stay was comparable between the Magtrace and 99mTc groups. Conclusions Magtrace shows comparable practicality, surgical implementation, and risk of complications to standard practices. Additionally, it offers a potential cost benefit.

摘要

背景 前哨淋巴结活检(SLNB)是用于确定无腋窝受累临床体征的乳腺癌患者分期的标准方法。目前腋窝术中评估的金标准是使用双放射性同位素和专利蓝色染料。然而,研究人员一直在研究使用超顺磁性氧化铁Magtrace®(英国剑桥Endomagnetics有限公司)试剂作为替代方法,以克服标准SLNB技术的局限性。

目的 本研究的目的是评估新型SentiMag®(英国剑桥Endomagnetics有限公司)技术与金标准相比的潜在等效性。主要终点包括每位患者的检测率和取出的淋巴结数量。

材料和方法 在英国罗瑟勒姆国民保健服务基金会信托基金进行了一项单中心回顾性研究,研究对象为2021年10月至2022年1月接受SLNB的患者。随机选择60名患者并分为两组:Magtrace组和锝-99m(99mTc)组。使用Fisher精确检验比较分类变量。进行学生t检验以比较连续变量。

结果 在接受Magtrace手术的患者组中观察到腋窝血清肿的发生率较高。与99mTc组的患者相比,Magtrace组患者的手术平均持续时间更长。接受99mTc的患者组中SLNB的检测率更高。两组在手术过程中取出的淋巴结数量相似。Magtrace组和99mTc组的住院时间相当。

结论 Magtrace在实用性、手术实施和并发症风险方面与标准做法相当。此外,它还具有潜在的成本效益。

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本文引用的文献

1
Axillary sentinel lymph node identification using superparamagnetic iron oxide versus radioisotope in early stage breast cancer: The UK SentiMag trial (SMART study).超顺磁性氧化铁与放射性同位素用于早期乳腺癌腋窝前哨淋巴结识别:英国SentiMag试验(SMART研究)
Surgeon. 2023 Apr;21(2):128-134. doi: 10.1016/j.surge.2022.04.006. Epub 2022 May 9.
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A Pilot Study Evaluating the Effects of Magtrace® for Sentinel Node Biopsy in Breast Cancer Patients Regarding Care Process Optimization, Reimbursement, Surgical Time, and Patient Comfort Compared With Standard Technetium.一项评估 Magtrace® 用于乳腺癌患者前哨淋巴结活检的影响的初步研究,与锝标准相比,该研究涉及护理流程优化、报销、手术时间和患者舒适度。
Ann Surg Oncol. 2021 Jun;28(6):3232-3240. doi: 10.1245/s10434-020-09280-1. Epub 2020 Dec 1.
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SentimagIC: A Non-inferiority Trial Comparing Superparamagnetic Iron Oxide Versus Technetium-99m and Blue Dye in the Detection of Axillary Sentinel Nodes in Patients with Early-Stage Breast Cancer.SentimagIC 试验:比较超顺磁性氧化铁与锝 99m 和蓝染料在检测早期乳腺癌患者腋窝前哨淋巴结中的非劣效性。
Ann Surg Oncol. 2019 Oct;26(11):3510-3516. doi: 10.1245/s10434-019-07577-4. Epub 2019 Jul 11.
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Technetium-99m radiochemistry for pharmaceutical applications.用于药物应用的锝-99m放射化学
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