Intradermal microbubbles and contrast-enhanced ultrasound (CEUS) is a feasible approach for sentinel lymph node identification in early-stage breast cancer.
Intradermal microbubbles and contrast-enhanced ultrasound (CEUS) is a feasible approach for sentinel lymph node identification in early-stage breast cancer.
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DOI：
10.1186/s12957-015-0736-x
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发表时间：
2015-11-19
影响因子：
3.2
通讯作者：
Wang S
中科院分区：
文献类型：
--
作者：
Xie F;Zhang D;Cheng L;Yu L;Yang L;Tong F;Liu H;Wang S;Wang S
微泡和超声造影（CEUS）是一种定位前哨淋巴结（SLN）的新技术。本研究的目的是探讨乳腺癌患者使用微泡通过 CEUS 追踪 SLN 的可行性以及增强模式在诊断淋巴结转移中的价值。临床试验已注册（试验注册：ChiCTR-DDT-13003778）。招募了一百零一名连续同意接受前哨淋巴结活检的乳腺癌患者。手术前，在乳晕周围注射微泡。术前通过CEUS探查淋巴引流通路，并放置导丝定位SLN。蓝色染料还用于在手术过程中帮助追踪前哨淋巴结。记录识别率和准确率。记录淋巴结强化模式并与病理诊断进行比较。在这101例中，99例SLN被至少一种示踪剂成功识别，其中98例通过CEUS识别，97例通过蓝色染料识别。两种方法之间没有显着性差异（P = 0.705）。 98例均成功置入导丝，且在后续手术中均成功隔离局部前哨淋巴结。 CEUS 分离的 SLN 状态与整个腋窝淋巴结完全相同，而 7.1% 的病例被蓝色染色法误诊为阴性。 CEUS增强模式预测SLN转移的敏感性为81.8%，特异性为86.2%，阳性和阴性预测值分别为75.0和90.3%。微泡和CEUS是SLN识别的可行方法。 CEUS 的增强模式可能有助于识别转移性前哨淋巴结。这种新颖的方法可能是一种有前景的临床应用技术。
Microbubbles and contrast-enhanced ultrasound (CEUS) is a new technique for locating sentinel lymph node (SLN). The aim of this study is to explore the feasibility of SLNs tracing by CEUS using microbubbles in breast cancer patients and the value of enhancing patterns in diagnosing lymph nodes metastases. A clinical trial was registered (trial registration: ChiCTR-DDT-13003778). One hundred and one consecutive consenting patients with breast cancer undergoing SLN biopsy were enrolled. Before the surgery, microbubble was injected periareolarly. Lymphatic drainage pathway was detected by CEUS, and guidewire was deployed to locate the SLN before the operation. Blue dye was also used to help in tracing sentinel lymph node during the operation. The identification rate and the accuracy rate were recorded. Enhancing patterns of lymph nodes were recorded and compared with the pathological diagnosis. Of the 101 cases, SLNs in 99 cases were successfully identified by at least one tracer, including 98 cases identified by CEUS and 97 cases by blue dye. There was no significant difference between the two methods (P = 0.705). Guidewires were deployed successfully in all 98 cases, and the localized SLNs were all isolated successfully in the following operations. The status of SLNs isolated by CEUS was completely identical to that of the whole axillary lymph node while 7.1 % cases were misdiagnosed as negative by blue dye method. The sensitivity of predicting SLNs metastases by CEUS enhancing pattern was 81.8 %, the specificity was 86.2 %, and the positive and negative predictive values were 75.0 and 90.3 %, respectively. Microbubbles and CEUS are feasible approaches for SLN identification. The enhancing patterns on CEUS may be helpful to recognize the metastasizing SLNs. This novel method may be a promising technique for the clinical application.