临床普外科电子杂志 ›› 2022, Vol. 10 ›› Issue (1): 50-.

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吲哚菁绿联合亚甲蓝示踪乳腺癌前哨淋巴结活检术的远期安全性研究

  

  1. 佛山市南海区妇幼保健院 乳腺科,广东 佛山 528200
  • 出版日期:2022-01-01 发布日期:2022-03-22

Long term safety of indocyanine green combined with methylene blue for sentinel lymph node biopsy in breast cancer

  1. Breast Department of Nanhai Maternal and Child Health Hospital in Foshan City,Guangdong Foshan 528200,China
  • Online:2022-01-01 Published:2022-03-22

摘要:

目的 观察吲哚菁绿联合亚甲蓝示踪乳腺癌前哨淋巴结活检术的远期安全性。方法 选取在佛山市南海区妇幼保健院2017 年6 月2018 年6 月收治腋窝临床阴性的40 例乳腺癌患者,均接受吲哚菁绿联合亚甲蓝示踪乳腺癌前哨淋巴结活检术(sentinel lymph nodes biopsy,SLNB)治疗,并进行长期随访至2021 年6 月。统计患者术后上肢淋巴水肿的情况,并分析患者区域淋巴结复发情况、无病生存及总生存率。结果 电话随访中40 例患者均完成随访,其中接受腋窝淋巴结清扫术(axillary lymph node dissection,ALND)手术的10 例患者中,其中出现了术后上肢淋巴水肿1 例患者(10.00%),而仅行SLNB 的患者另30 例中,其中出现了术后上肢淋巴水肿3 例患者(10.00%),经对症治疗后好转,两组比较,差异无显著性(P > 0.05)。本研究纳入40 例患者中,3 例出现区域淋巴结复发,2 例出现对侧乳腺癌,4 例出现远处转移,其中接受ALND 手术的10例患者中1 例区域淋巴结复发(10.00%),1 例对侧乳腺癌(10.00%),3 例远处转移(10.00%),而仅行SLNB 的患者另30 例中2 例区域淋巴结复发(6.67%),1 例对侧乳腺癌(3.33%),3 例远处转移(10.00%),两组比较,差异无显著性(P > 0.05)。随访期内死于乳腺癌远处转移者2 例,死亡率6.67%。无病生存率为85.00%,总生存率为95.00%。结论 吲哚菁绿联合亚甲蓝示踪乳腺癌前哨淋巴结活检术的远期安全性高。

关键词: 吲哚菁绿, 亚甲蓝, 联合示踪, 乳腺癌, 前哨淋巴结活检术, 远期安全性

Abstract:

Objective To observe the long-term safety of indocyanine green combined with methylene blue in tracing sentinel lymph node biopsy in breast cancer. Method 40 breast cancer patients with axillary negative clinical findings in Nanhai Maternal and Child Health Hospital in Foshan City from June 2017 to June 2018 were treated with indocyanine green combined with methylene blue for sentinel lymph node biopsy and followed up for 06 months in 2021. The situation of postoperative upper limb lymphedema was counted, and the regional lymph node recurrence, disease-free survival and overall survival rate were analyzed. Result In the telephone follow-up, 40 patients completed the follow-up. Among the 10 patients who underwent ALND operation, 1 patient (10.00%) had postoperative upper limb lymphedema, while among the other 30 patients who underwent SLNB only, 3 patients (10.00%) had postoperative upper limb lymphedema, which improved after symptomatic treatment. There was no significant difference between the two groups (P > 0.05). Of the 40 patients, 3 had regional lymph node recurrence, 2 had contralateral breast cancer, and 4 had distant metastasis. Among the 10 patients receiving ALND, 1 had regional lymph node recurrences (10%), 1 had contralateral breast cancer (10%) and 3 had distant metastasis (10%), while only SLNB patients had regional lymph node recurrence (3). There were 1 cases of contralateral breast cancer (3.33%) and 3 cases of distant metastasis (10%). The difference between the two groups was not significant (P > 0.05). 2 patients died of distant metastasis of breast cancer during the follow-up period, with a mortality rate of 6.67%. DFS was 85.00%, 0s was 95.00%. Conclusion Indocyanine green combined with methylene blue for tracing sentinel lymph node biopsy in breast cancer has long term safety and is worthy of clinical application.

Key words: Indocyanine green, Methylene blue, Combined tracer, Mammary cancer, Sentinel lymph node biopsy, Long term safety