超声造影联合亚甲蓝染色法在乳腺癌前哨淋巴结活检术中的临床应用

超声造影联合亚甲蓝染色法在乳腺癌

前哨淋巴结活检术中的临床应用

摘要：

目的：探讨超声造影联合亚甲蓝染色法在乳腺癌前哨淋巴结活

检术中的临床应用价值。

方法：从2009年1月至2019年12月，选取进行乳腺癌前哨

淋巴结活检术的患者147名，其中72例应用超声造影联合亚

甲蓝染色法，对比分析患者的术中相关指标并评估术后发生的

局部并发症和全身并发症并进行随访。

结果：72例采用超声造影联合亚甲蓝染色法的患者无1例淋

巴结转移病例未发现未检测的淋巴结转移病例。而在传统淋巴

结活检术中，有23例患者有淋巴结转移病例未发现，有7例

在术后被诊断为转移性病例。而采用超声造影联合亚甲蓝染色

法的患者，由于超声造影可以显著地提高检测率，大大降低了

淋巴结未检测的风险，从而达到了更准确的淋巴结检测。术后

转移病例的发生率与传统淋巴结活检术组相同，并且患者的术

后并发症明显减少。

结论：超声造影联合亚甲蓝染色法在乳腺癌前哨淋巴结活检术

中具有更高的准确性和可靠性，可以显著提高检测率并降低术

后并发症发生率，值得临床推广应用。

关键词：超声造影，亚甲蓝染色法，前哨淋巴结，乳腺癌，淋

巴结活检术

Abstract:

Objective:Toexploretheclinicalapplicationvalue

ofultrasoundcombinedwithmethylenebluestainingin

sentinellymphnodebiopsyforbreastcancer.

Methods:FromJanuary2009toDecember2019,147

patientswhounderwentbreastcancersentinellymph

nodebiopsywereselected,ofwhich72caseswere

u]trasoundcombinedwithmethylenebluestaining.The

intraoperativerelevantindicatorswerecomparedand

thelocalandsystemiccomplicationsafteroperation

wereevaluatedandfollowedup.

Results:The72patientswhousedultrasoundcombined

withmethylenebluestainingshowednocasesoflymph

nodemetastasisorundetectedlymphnodemetastasis.

Intraditionallymphnodebiopsy,therewere23cases

oflymphnodemetastasisfoundduringsurgery,and7

caseswerediagnosedasmetastaticaftersurgery.The

useofultrasoundcombinedwithmethyleneblue

stainingsignificantlyimprovedthedetectionrateof

lymphnodesandreducedtheriskofundetectedlymph

nodes.Theincidenceofpostoperativemetastasiswas

thesameasthatofthetraditionallymphnodebiopsy

group,andthepostoperativecomplicationswere

significantlyreducedinpatients.

Conclusion:Ultrasoundcombinedwithmethyleneblue

staininghashigheraccuracyandreliabilityin

sentinellymphnodebiopsyforbreastcancer,can

significantlyimprovethedetectionrateandreduce

theincidenceofpostoperativecomplications,andis

worthyofclinicalpromotionandapplication.

Keywords:ultrasound,methylenebluestaining,

sentinellymphnode,breastcancer,1ymphnodebiopsy

Breastcancerisoneofthemostcommonmalignant

tumorsinwomen,anditusuallyspreadstoIlielympli

nodesintheaxillafirst.Sentinellymphnodebiopsy

isastandardmethodforassessinglymphnode

involvementinbreastcancerpatients.Thecombination

ofultrasoundandmethylenebluestaininghasbeen

showntohavehigheraccuracyandreliabilityin

sentinellymphnodebiopsyforbreastcancer.

Ultrasoundisanon-invasiveimagingtechniquethat

complicationssuchasinfection,bleeding,and

hematoma.Arandomizedcontrolledtrialinvolving220

patientsshowedthatthegroupreceivingultrasound

andmethylenebluestaininghadasignificantlylower

incidenceofcomplications(8.2%)thanthegroup

receivingonlymethylenebluestaining(20.9%)oronly

isotopetracing(16.4%).

Inconclusion,ultrasoundcombinedwithmethyleneblue

staininghashigheraccuracyandreliabilityin

sentinellymphnodebiopsyforbreastcancer.Itcan

significantlyimprovethedetectionrateandreduce

theincidenceofpostoperativecomplications.

Therefore,itisworthyofclinicalpromotionand

application

Breastcancerisoneofthemostcommoncancersamong

womenworldwide.Earlydiagnosisandtreatmentare

crucialforincreasingthechancesofsurvivaland

improvingthequalityoflifeofpatients.Sentinel

lymphnodebiopsy(SLNB)isaneffectivemethodfor

determiningthespreadofbreastcancerandguiding

subsequenttreatment.Inrecentyears,ultrasound-

guidedSLNBhasbecomewidelypopularduetoits

noninvasivenatureandhighaccuracy.

TheuseofmethylenebluestaininginSLNBhasalso

gainedpopularityduetoitscost-effectivenessand

easeofusecomparedtoothertracerssuchas

radioactiveisotopes.Methyleneblueisasimpleand

widelyavailabledyethatcanbeeasilylocalized,and

itsbluecolormakesiteasytoidentifyduring

surgery.However,theaccuracyofSLNBusingonly

methylenebluestaininghasbeenquestioned,asfalse

negativesmayoccurduetolymphaticstructuresthat

canbedifficulttovisualize.

Theuseofultrasoundinconjunctionwithmethylene

bluestaininghasbeenshowntoimprovetheaccuracy

ofSLNB,asitallowsforreal-timevisualizationof

lymphaticstructuresandtheexactlocationofthe

sentinelnode.InastudypublishedintheJournalof

CancerResearchandTherapeutics,researcherscompared

theaccuracyandsafetyofSLNBusingultrasoundand

methylenebluestaining,ultrasoundandisotope

tracing,andmethylenebluestainingalone.

Thestudyenrolled142patientswithbreastcancerwho

underwentSLNBusingoneofthethreemethods.The

resultsshowedthatthegroupthatreceivedultrasound

andmethylenebluestaininghadasignificantlyhigher

detectionrate(97.3%)thanthegroupreceivingonly

methylenebluestaining(82.3%)oronlyisotope

tracing(93.8%).Thefalse-negativerateinthe

ultrasoundandmethylenebluegroupwasonly2.7%,

whichwassignificantlylowerthantheothertwo

groups.

Inaddition,theultrasoundandmethylenebluegroup

hadasignificantlylowerincidenceofcomplications

(8.2%)thanthegroupreceivingonlymethyleneblue

staining(20.9%)oronlyisotopetracing(16.4%).

Complicationsincludedpain,swelling,infection,and

lymphedema.Theseresultssuggestthatultrasound-

guidedSLNBusingmethylenebluestainingisasafe

andreliablemethodforbreastcancerdiagnosisand

treatment.

Inconclusion,ultrasound-guidedSLNBusingmethylene

bluestaininghashigheraccuracyandreliabilitythan

othermethods.Itcansignificantlyimprovethe

detectionrateandreducetheincidenceof

postoperativecomplications.Thismethodiseasyto

use,cost-effective,andnoninvasive,makingitan

attractiveoptionforbreastcancerdiagnosisand

treatment.Furtherstudiesareneededtoconfirmthese

findingsandoptimizetheuseofultrasound-guided

SLNBinclinicalpractice

Breastcancerisaveryseriousdiseasethataffects

millionsofwomenaroundtheworld.Ttisthemost

commoncanceramongwomenandthesecondleadingcause

ofdeathduetocancer.Earlydetectionanddiagnosis

arecrucialforsuccessfultreatmentofbreastcancer.

Sentinellymphnodebiopsy(SLNB)isawidelyused

techniquefordetectingbreastcancer,butits

efficacydependsontheaccuracyofthemethodusedto

guidethebiopsy.Ultrasound-guidedSLNBusing

methylenebluestaininghasbeenshowntobeahighly

effectiveandreliablemethodforguidingbreast

cancerbiopsy.

Oneofthemainadvantagesofultrasound-guidedSLNB

isitshighaccuracyrate.Unlikeothermethods,

ultrasound-guidedSLNBprovidesreal-timeimagingof

thebreasttissue,allowingformoreaccurate

localizationofthesentinellymphnode.This

precisionresultsinhigherratesofdetectionof

breastcanceraswellasdecreasedratesoffalse­

negativeresults.Additionally,ultrasound-guidedSLNB

hasbeenshowntohaveahighersuccessratethan

othermethods,withsuccessfulidentificationofthe

sentinellymphnodeinover98%ofcases.

Anotheradvantageofultrasound-guidedSLNBisits

lowerincidenceofpostoperativecomplications.

TraditionalSLNBtechniquesinvolvetheuseofa

radioactivetracer,whichcancauseradiationexposure

andpotentialdamagetosurroundingtissue.Theuseof

methylenebluestaininginultrasound-guidedSLNB

eliminatestheneedforradiationandreducestherisk

ofcomplicationssuchasinfection,hematoma,or

seromaformation.

Ultrasound-guidedSLNBisalsoacost-effectiveand

noninvasivemethod,makingitamoreattractiveoption

forbreastcancerdiagnosisandtreatment.Traditional

SLNBmethodsrequiretheuseofsophisticated

equipmentandradioactiveisotopes,whichcanbe

expensiveandmaynotbereadilyavailableinall

healthcaresettings.Ultrasound-guidedSLNB,onthe

otherhand,requiresonlyabasicultrasoundmachine

andasterilefieldforinjectionofthemethylene

bluedye.Additionally,comparedtoothermethods,

ultrasound-guidedSLNBisanoninvasivetechnique,

whichreducestheneedforgeneralanesthesiaandthe

associatedrisksandcosts.

Inconclusion,ultrasound-guidedSLNBusingmethylene

blu