研究动态
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超声造影在乳腺癌前哨淋巴结定位和诊断中的优势。

Advantages of contrast-enhanced ultrasound in the localization and diagnostics of sentinel lymph nodes in breast cancer.

发表日期:2023 Nov 15
作者: Qiuhui Yang, Yeqin Fu, Jiaxuan Wang, Hongjian Yang, Xiping Zhang
来源: Journal of Zhejiang University-SCIENCE B

摘要:

前哨淋巴结(SLN)是从乳腺肿瘤延伸至腋窝淋巴引流的淋巴结的第一站。这些淋巴结的病理状态可以预测整个腋窝淋巴结的病理状态。因此,准确识别前哨淋巴结对于前哨淋巴结活检(SLNB)取代腋窝淋巴结清扫术(ALND)是必要的。乳腺癌患者的生活质量和预后与准确识别SLN后正确的手术治疗有关。一些已被识别的 SLN 示踪剂包括放射性同位素、纳米碳、吲哚菁绿 (ICG) 和亚甲基蓝 (MB)。然而,这些示踪剂具有一定的局限性,例如色素沉着、辐射危险以及需要昂贵的检测设备。超声造影剂(UCA)具有良好的特异性和敏感性,因此可以弥补上述示踪剂的一些缺点。该技术也被应用于乳腺癌患者的SLNB,甚至可以对SLN状态提供初步判断。超声造影(CEUS)具有区分度高、操作简单、无辐射危害、成本低、定位准确等优点;因此,它有望取代传统的活检方法。此外,它还可以显着提高SLN定位的精度并缩短手术时间。
Sentinel lymph nodes (SLNs) are the first station of lymph nodes that extend from the breast tumor to the axillary lymphatic drainage. The pathological status of these LNs can predict that of the entire axillary lymph node. Therefore, the accurate identification of SLNs is necessary for sentinel lymph node biopsy (SLNB) to replace axillary lymph node dissection (ALND). The quality of life and prognosis of breast cancer patients are related to proper surgical treatment after the precise identification of SLNs. Some of the SLN tracers that have been identified include radioisotope, nano-carbon, indocyanine green (ICG), and methylene blue (MB). However, these tracers have certain limitations, such as pigmentation, radiation dangers, and the requirement for costly detection equipment. Ultrasound contrast agents (UCAs) have good specificity and sensitivity, and thus can compensate for some shortcomings of the mentioned tracers. This technique is also being applied to SLNB in patients with breast cancer, and can even provide an initial judgment on SLN status. Contrast-enhanced ultrasound (CEUS) has the advantages of high distinguishability, simple operation, no radiation harm, low cost, and accurate localization; therefore, it is expected to replace the traditional biopsy methods. In addition, it can significantly enhance the accuracy of SLN localization and shorten the operation time.