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Received:August 30, 2024 Published Online:October 20, 2024
Received:August 30, 2024 Published Online:October 20, 2024
中文摘要: b>目的 探讨99mTc-硫胶体(99mTc-SC)淋巴结显像联合亚甲蓝示踪在前哨淋巴结活检(SLNB)中的应用及其对腋窝淋巴结转移的评估意义及安全性。方法 选取2017年12月至2022年12月于珠海市中西医结合医院收治的乳腺癌患者121例,随机分为亚甲蓝组(n=41)、99mTc-SC组(n=40)及联合组(n=40)。所有患者进行亚甲蓝、99mTc-SC核素显像或二者联合示踪行SLNB并随后行腋窝淋巴结清扫术(ALNB)。以ALND病理结果为准,分析三种方法对前哨淋巴结的诊断效能。〖HTH〗结果〓〖HTSS〗结果显示,腋窝前哨淋巴结检出准确率、特异度、灵敏度、假阴性率方面三组之间差异无统计学意义(P>0.05)。腋窝阳性淋巴结检出个数在亚甲蓝组(2.79±0.98)、99mTc-SC组(3.25±1.25)和联合组(3.97±1.06)依次增加(F=11.78,P<0.01),两两比较,差异亦有统计学意义(P<0.05)。亚甲蓝组、联合组各发生4例、1例尿液蓝染,且所有患者在24 h内尿液颜色均恢复正常,未观察到其他不良反应。结论 99mTc-SC联合亚甲蓝作为SLNB的示踪方法,能够提高腋窝阳性淋巴结检出个数,此方法在乳腺癌SLNB中具有较高的应用价值。
Abstract:ObjectiveTo investigate the application of 99mTc-sulfur colloid (99mTc-SC) lymph node imaging with methylene blue tracing during sentinel lymph node biopsy (SLNB) procedures and its importance in evaluating axillary lymph node metastasis and safety. Methods A total of 121 breast cancer patients admitted to Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from December 2017 to December 2022 were selected,and were randomly divided into the methylene blue group(n=41), the 99mTc-SC group (n=40)and combination group(n=40). All patients recevied SLNB under the tracing of methylene blue, 99mTc-SC radionuclide imaging, or the combination of the two ,and followed by axillary lymph node dissection. Based on the pathological results after SLNB, the diagnostic efficiency of three methods for sentinel lymph nodes was analyzed.Results There was no significant difference in the detection accuracy, specificity, sensitivity and false negative rate of axillary sentinel lymph nodes among the three groups (P>0.05).The detected number of axillary positive lymph nodes in methylene blue group (2.79±0.98), 99mTc-SC group (3.25±1.25), and combination group (3.97±1.06) increased sequentially (F=11.78, P<0.01), and the differences of pairwise comparisons were also statistically significant (P<0.05). Urine blue staining occurred in 4 cases of methylene blue group and 1 case of combined group, and the urine color of all patients returned to normal within 24 hours, and〖JP〗 〖LM〗no other adverse reaction was observed. Conclusion The combination of 99mTc-SC and methylene blue as a tracer can improve the detected number of axillary positive lymph nodes, which has high application value in SLNB of breast cancer.
keywords: Methylene blue 99mTc-sulfur colloid Sentinel lymph node biopsy Breast cancer Lymph node metastasis
文章编号: 中图分类号:R737.9 文献标志码:A
基金项目:珠海市社会发展领域科技计划项目(2320004000321)
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