| Objective: The new probe is equipped with Bluetooth using the sentinel lymph node tracker Neo 2000TM detection of breast cancer SLN, through the detection rate of SLN detection rate and sensitivity comparison analysis shows that the improvement, while against the increase in sensitivity will lead to the occurrence of false-positive rate to analyze.Methods: 40 cases of breast cancer patients were divided into two chronological groups, the first group of 20 patients underwent SLN preoperative ultrasonography (color Doppler Model: Hewlett-Packard ultrasound HP-L7535) check for surface positioning and marked. 3 hours before surgery by radionuclide method routine testing SLN, radionuclide materials 99mTc-SC (99m Tc sulfur colloid mixture: 99m Tc provided by the Swedish Amersham; sulfur colloid by the Beijing Normal macro Pharmaceutical Co. From the Jilin University Third Clinical Hospital, Department of Nuclear Medicine line marker, mark rate of 96% to 97%, application of the dose 1.0Mci/2ml), was injected into the edge of the areola 3,6,9,12 o'clock, every point intradermal injection 0.5ml, 2 hours after ECT lymph scintigraphy to identify the SLN imaging and ultrasound findings are consistent with the location of the SLN. If you are not under the ECT imaging, then apply the new Australia 2000TM sentinel lymph node tracker (configuration cable type hand-heldγprobe - produced by the United States Johnson & Johnson) for the location of SLN detection surface, and then compared with ultrasound imaging. 15 minutes before surgery in the primary tumor were injected around 4:00 2ml methylene blue injection. Intraoperative SLN tracker confirmed a higher radioactive SLN, and the lymph nodes were stained blue. Found in the lymph nodes near the blue stained lymph nodes were not also need to be removed, the removal of the SLN intraoperative rapid pathological submission. 20 cases of breast cancer after taking the same approach is adopted for the new Australian 2000TM sentinel lymph node is equipped with Bluetooth hand-held tracker isotope detector, it is Johnson & Johnson upgraded to improve the SLN detector, its sensitivity is not an upgrade over the high up 50%. All patients underwent radical / modified radical mastectomy, according to the respective needs of different regions of the lymph node biopsy censorship.Results: The first group of patients appears a false negative patients, 1 case was successfully detected SLN, paraffin pathology SLN metastasis in 8 patients were presented, including color Doppler suspected metastasis in 6 cases, 2 cases incompatible with the pathological results (including false-negative patients 1). More than 11 cases of SLN metastasis, ultrasonography and pathological findings consistent with ultrasound diagnosis and pathologic diagnosis accordance rate (17/19) 89.5%, 20 cases of SLN detection rate (19/20) 95%. False negative rate: 1 case of false negative patients / success detection SLN19 cases×100% = 5.3%, false positive rate of 0%, sensitivity: SLN true positive in 8 cases / (SLN true positive in 8 cases + ALN positive one case of a single deposit)×100% = 88.9%. In the preoperative surface marking tracker SLN identified and the average time is as follows: (depending on the quadrant, the average detection time is different) the upper outer quadrant 5.5 minutes / 10 cases, outer inferior quadrant 3.5 minutes / 3 cases, within the Quadrant 2.0 minutes / 3 cases, lower quadrant within 2.5 minutes / 1, areola, under 2 minutes / 2 cases, the average time of 3.1 minutes / 19 cases. Patients through the detection of lessons learned and develop the learning curve.The second group of patients with the same method, 20 patients were successfully detected in SLN, no false negative and false-positive cases, of which 6 cases were suspected to have SLN metastasis ultrasound, 1 case of discrepancies with the pathological results in 13 cases without metastasis SLN color Doppler ultrasound and pathology results found. And draw the whole ultrasound diagnosis and pathologic diagnosis of compliance rate (19/20) 95.0%, false negative rate: 0 cases of false negative patients / success detection SLN20 cases×100% = 0%, false positive rate of 0%, SLN review Ratio (20/20) 100%. Sensitivity: SLN true positive in 7 cases / (SLN 7 cases of true positive + single deposit ALN positive 0 cases)×100% = 100%. Tracker preoperative SLN identified and the average surface markers when used as follows: the upper outer quadrant 2.5 minutes / 11 cases, outer inferior quadrant 2.5 minutes / 7 cases, within the upper quadrant of 1.5 minutes / 2 cases, the average time of 2.2 minutes / 20 cases.A total of 40 patients detected 85 SLN, SLN average number of 2.13 cases, the overall color Doppler prediction accuracy rate of SLN metastasis (36/39) 92.3%. The second group of preoperative SLN detection and to the average surface marked with a certain increase when the second group had no false-negative patients, two groups of patients with no false positives.Conclusion: 1, Neo 2000TM sentinel lymph node tracker upgraded and improved for the Bluetooth probe, by contrast sensitivity in both groups (88.9% to 100%) and comparison of detection rates (95% to 100%), indicating that the new SLN Tracker The probe sensitivity has been greatly improved. 2, according to preoperative SLN tracker for surface marker detection and the time spent SLN contrast, the detection time was significantly increased. 3, color Doppler ultrasound to predict the location and orientation SLN metastasis has a higher accuracy, ultrasonography diagnosis and final pathological diagnosis consistent with the rate reached 92.3%. |
