Three-dimensional visual technique based on CT lymphography data combined with methylene blue in endoscopic sentinel lymph node biopsy for breast cancer.
Three-dimensional visual technique based on CT lymphography data combined with methylene blue in endoscopic sentinel lymph node biopsy for breast cancer.
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DOI：
10.1186/s40001-022-00909-3
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发表时间：
2022-12-04
影响因子：
4.2
通讯作者：
Zhang, Pusheng
中科院分区：
文献类型：
--
作者：
Wang, Baiye;Ou, Caifeng;Yu, Jingang;Ye, Jianping;Luo, Yunfeng;Wang, Yu;Zhang, Pusheng
蓝色染料和放射性同位素的联合应用是目前用于乳腺癌前哨淋巴结活检（SLNB）的主要作图技术。然而，由于对放射性物质的严格限制，放射性胶体技术尚未得到广泛采用，特别是在发展中国家。因此，我们进行了一项回顾性研究，以评估基于CT-LG的三维可视化技术（3DVT）在乳腺癌内窥镜前哨淋巴结活检（ESLNB）中的可行性和准确性。本研究纳入2018年9月至2020年6月在我科接受手术治疗的389例乳腺癌患者。将患者CT-LG数据重建为数字3D模型，导入Smart Vision Works V1.0，定位前哨淋巴结（sentinel lymph node， SLN），进行视觉模拟手术。在此基础上进行了ESLNB和内镜下腋窝淋巴结清扫；分析3DVT在ESLNB中的准确性及临床应用价值。重建的三维模型清晰地显示了乳房和腋窝的所有结构，有利于术中发现sln。活检sln的检出率为100%（389/389）。准确率为93.83%(365/389)，灵敏度为93.43%(128/137)，假阴性率为6.57%（9/137）。1例患者术后3个月出现上肢淋巴水肿，随访12个月。我们基于CT-LG数据的3DVT结合ESLNB中的亚甲基蓝，确保了sln的高识别率和低假阴性率。因此，它有可能作为乳腺癌病例SLN活检的新方法。
The combined application of blue dye and radioisotopes is currently the primary mapping technique used for sentinel lymph node biopsy (SLNB) in breast cancer patients. However, radiocolloid techniques have not been widely adopted, especially in developing countries, given the strict restrictions on radioactive materials. Consequently, we carried out a retrospective study to evaluate the feasibility and accuracy of three-dimensional visualization technique (3DVT) based on computed tomography-lymphography (CT-LG) in endoscopic sentinel lymph node biopsy (ESLNB) for breast cancer. From September 2018 to June 2020, 389 patients who underwent surgical treatment of breast cancer in our department were included in this study. The CT-LG data of these patients were reconstructed into digital 3D models and imported into Smart Vision Works V1.0 to locate the sentinel lymph node (SLN) and for visual simulation surgery. ESLNB and endoscopic axillary lymph node dissection were carried out based on this new technique; the accuracy and clinical value of 3DVT in ESLNB were analyzed. The reconstructed 3D models clearly displayed all the structures of breast and axilla, which favors the intraoperative detection of SLNs. The identification rate of biopsied SLNs was 100% (389/389). The accuracy, sensitivity, and false-negative rate were 93.83% (365/389), 93.43% (128/137), and 6.57% (9/137), respectively. Upper limb lymphedema occurred in one patient 3 months after surgery during the 12-month follow-up period. Our 3DVT based on CT-LG data combined with methylene blue in ESLNB ensures a high identification rate of SLNs with low false-negative rates. It, therefore, has the potential to serve as a new method for SLN biopsy in breast cancer cases.
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影响因子：
51.1
作者：
Galimberti, Viviana;Cole, Bernard F.;Goldhirsch, Aron
通讯作者：
Goldhirsch, Aron
DOI：
10.1007/s00464-014-3808-z
发表时间：
2015-06-01
影响因子：
3.1
作者：
Zhang, Pusheng;Luo, Yunfeng;Huang, Zonghai
通讯作者：
Huang, Zonghai
DOI：
10.6004/jnccn.2019.5006
发表时间：
2019-05-01
影响因子：
13.4
作者：
Telli, Melinda L.;Gradishar, William J.;Ward, John H.
通讯作者：
Ward, John H.
影响因子：
2.5
作者：
Shen, Songjie;Xu, Qianqian;Sun, Qiang
通讯作者：
Sun, Qiang
影响因子：
9.6
作者：
Hung, WK;Chan, CM;Yip, AWC
通讯作者：
Yip, AWC