The Clinical Value Of The Use Of Carbon Nanoparticle Suspension Injection For Sentinel Lymph Node Biopsy In Breast Cancer

Background:Sentinel lymph node biopsy(SLNB)has been proved to be a useful and accurate procedure for assessing the regional lymph node status in patients with early-stage breast cancer.Patients without sentinel lymph node(SLN)metastases should not undergo axillary lymph node dissection(ALND).SLNB could decrease the morbidity of side effects,such as numbness,limb swelling and stiffness,by avoiding aggressive axillary treatment.At present,the internationally recognized tracing methods of SLNB mainly include radionuclide,staining and combination of the first two.However,the traditional methods have some drawbacks such as radioactivity,complex operation,allergic reaction,short dyeing time and cutaneous necrosis.Carbon nanoparticle suspension injection(CNP)is a novel SLN tracer with a safety profile and good target efficiency.CNP are activated carbon products processed by nanotechnology,which have a smooth and uniform diameter of 21 nm.However,there were a few studies concern about CNP at present.In the current study,a randomized controlled analysis was performed to compare the tracing efficacy of CNP with methylene blue,and validate the clinical usefulness of CNP in guiding SLNB for early breast cancer.Objective:To evaluate the clinical value and advantage of carbon nanoparticle suspension injection in the diagnosis of sentinel lymph nodes(SLN)for early breast cancer.Methods:A total of 104 breast cancer patients in our hospital were enrolled in this prospective,randomized controlled trial and were randomly divided into two equal groups: experimental group(carbon nanoparticle suspension injection)and control group(methylene blue).Patients of experimental group were injected carbon nanoparticle suspension injection and cases of control group were injected methylene blue(MB).All cases of two groups were taken sentinel lymph node biopsy(SLNB)and then underwent axillary lymph node dissection(ALND).The study analyzed the detection rate,false negative rate,accuracy rate and sensitivity.Results:1.The mean number of the dissected SLN per patient was significantly higher in the experimental group(4.3±1.8)than in the control group(2.6±1.2)(P<0.05).2.In the experimental group,the detection rate was 100%(52/52),the false negative rate was 5.9%(1/17),the accuracy rate was 98.1%(51/52)and the sensitivity was 94.1%(16/17).In the control group,the detection rate was 96.2%(50/52),the false negative rate was 10.5%(2/19),the accuracy rate was 92.3%(48/52)and the sensitivity was 89.5%(17/19).There were no significant difference in the detection rate,false negative rate,accuracy rate and the sensitivity between two groups(P>0.05).Conclusion:1.The efficacy of CNP is not inferior to the traditional tracer MB,it could accurately predict the axillary lymph node status for patients with early breast cancer(tumor size ?5cm with no enlarged lymph nodes found by axillary palpation).2.CNP could help increase the number of SLN,which is a safe and efficient tracer for SLND.Therefore,it has promising and strong application prospects in clinical practice.