孙嘉忆^1,,
郭文斌^1,,,
张天一²
1. 大连医科大学附属大连市中心医院 乳腺外二科, 辽宁 大连 116033
2. 大连医科大学 研究生院, 辽宁 大连 116044

详细信息 作者简介: 孙嘉忆(1985-), 女, 硕士研究生。E-mail: 12150004@qq.com



通讯作者: 郭文斌, 教授。E-mail: drguowb@hotmail.com 中图分类号: R737.9


摘要:目的评估吲哚菁绿（indocyanine green，ICG）引导技术在不可触及乳腺癌（nonpalpable breast cancer，NBC）病变定位切除术（ICG-guided NBC lesion localization，INBCL）中的使用效果。方法回顾性分析2009年11月至2013年9月大连市中心医院乳腺外二科所有术前超声和乳腺钼靶下可见，并经穿刺活检诊断为NBC，且接受肿物切除活检术的62例患者的临床资料。根据术中定位方式的不同，分为2009年11月至2011年10月的导丝定位（wire localization，WL）组30例，和2011年9月至2011年10月的INBCL组32例。比较两组患者手术时间及术中肿物切除情况。结果两组患者最终均100%切除病灶。INBCL组的首次切缘阴性率为87.5%（28/32），高于WL组的63.3%（19/30），差异有统计学意义（P=0.026）。平均切除肿物体积分别为INBCL组51.8（24.6，59.7）cm³，WL组65.4（30.1，118.4）cm³；手术时间分别为INBCL组29（27，32）min，WL组25（23，52）min，两组间比较差异均无统计学意义（P>0.05）。结论对于NBC行保乳手术的患者，应用INBCL具有切缘阴性率更高、乳腺健康组织损失更少的优势。
关键词: 吲哚菁绿荧光引导切除/
切缘状态/
不可触及乳腺癌/
导丝定位引导切除


Abstract:ObjectiveTo evaluate the effect of indocyanine green (ICG) guided technique in the localized resection of nonpalpable breast cancer (NBC).MethodsA retrospective analysis was performed in all 62 cases of NBC, which were identified by preoperative ultrasound and mammography, diagnosed by needle biopsy, and resected for pathologic examination from November 2009 to September 2013 in the Second Department of Breast Surgery, Dalian Central Hospital of Dalian Medical University. According to the different localization methods, 30 cases were in the wire localization (WL) group from November 2009 to October 2011, and 32 cases ICG-guided NBC lesion localization (INBCL) group from September 2011 to October 2011. Operation time and indicators of intraoperative tumor resection were compared between the two groups.ResultsThe lesions were 100% resected in both groups eventually. Compared with the WL group (63.3%, 19/30), the first negative margin rate in the INBCL group was much higher (87.5%, 28/32) (P=0.026). Although the differences of mean resection volume and operation time were not significant (P>0.05), the INBCL group had less normal tissue loss than the WL group. The mean resection volume of the INBCL group was (56.2±2.8) cm³, while the WL group was (72.3±5.6) cm³.ConclusionFor NBC patients undergoing BCS, the application of INBCL has the advantages of higher negative margin rate and less loss of normal breast tissue.
Keywords:INBCL/
margin status/
nonpalpable breast cancer/
wire localization

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