| Objective: Sentinel lymph node biopsy tracers commonly used in breast cancer include dyes,nuclide and fluorescent agents.We performed a biopsy of the axillary sentinel lymph node of breast cancer using a dye nano-carbon combined with a fluorescein green phthalocyanine,and compared the detection rate of SLN detected by the combination of nano-carbon-fluorescent agent and single-use nano-carbon,single-use fluorescent agent,and the number of detected SLNs.,positive detection rate,positive number of SLN detected,thus evaluating the advantages and value of nano-carbon-fluorescein combination in clinical application.Methods:Prospective collection of 113 cases of early-stage breast cancer patients with negative palpation of axillary lymph nodes before surgery in the Second Affiliated Hospital of Guangxi Medical University,First Affiliated Hospital of Guangxi Medical University from September 2017 to March 2018.CNP and ICG were combined during surgery.As a tracer line SLNB,black-stained,fluorescent,or both black-stained and fluorescent lymph nodes are regarded as SLNs and the detected SLN-classified specimen bags(bag No.1 : black-stained SLN,bag No.2 : simple Fluorescent SLN,No.3 bag: both black and fluorescent SLN),immediately sent to the frozen pathological examination.Pure black dye + pure fluorescence + SLN with both black stain and fluorescence as a combination group,black stain + SLN with both black stain and fluorescence as a nano carbon group,pure fluorescence + both black and fluorescent SLN was used as the ICG group.The number of SLNs detected in the combined group,the nano-carbon group,and the ICG group was recorded,the number of SLNs detected,the number of SLN-positive cases,the number of positive SLNs detected,the pairwise comparison and analysis combined group,and the nano-carbon group.ICG group’s detection rate,positive detection rate,SLN average detection number,positive SLN average detection number difference was statistically significant,the mean was represented by XS,count data analysis using 2 test,measurement data analysis using T test P < 0.05 was considered statistically significant.Results: 1.The detection rates of the combined group,the nano-carbon group,and the ICG group were 97.3%,91.2%,and 92.0%,respectively;the combined group was higher than the nano-carbon group,and the difference was not statistically significant(2=2.93,P= 0.083);The combination group was higher than the ICG group,the difference was not statistically significant(2 =2.2,P = 0.135);ICG group was higher than the nano-carbon group,the difference was not statistically significant(2 = 0.06,P = 1.000).2.The average number of SLNs detected in the combined group,nano-carbon group,and ICG group was 4.16±2.48 pieces/case,3.03±2.21pieces/case,and 3.58±2.64 pieces/case respectively;the combination group was more than the nano-carbon group.The difference was statistically significant(T=8.08,P=0.000);the combined group was more than the ICG group,thedifference was statistically significant(T=4.94,P=0.000);the ICG group was more than the nano-carbon group,the difference was statistically significant(T=2.78,P=0.006).3.The positive rates of SLN in the combined group,nano-carbon group and ICG group were 35.4%(40/113),29.2%(33/113),and 32.7%(37/113),respectively;the positive rate of positive SLN in the combination group was higher than that of nano-carbon.There was no statistically significant difference between the two groups(2=1.00,P=0.393).The positive rate of SLN in the combined group was higher than that of the ICG group,which was not statistically significant(2=0.17,P=0.390).The positive rate of SLN in the ICG group was higher than that of the nanomolecule group.In the carbon group,there was no statistical significance(2=0.33,P=0.565).4.The average number of positive SLN detected in the combined group,nano-carbon group,and ICG group was 2.20+1.67 pieces/case,1.58±1.30pieces/case,2.03±1.75 pieces/case respectively;the combination group was more than the nano-carbon group,and the difference was Statistical significance(T=3.84,P=0.000);Combination group was more than ICG group,the difference was statistically significant(T=2.48,P=0.018);ICG group was more than nano-carbon group,the difference was statistically significant(T =2.47,P=0.018).5.There were 33 cases of positive SLN detected in nano-carbon group,among which 28 cases were positive SLN number 1-2,5 cases were ≥ 3 cases,and the number of positive SLN detected after combined ICG was1-2 cases was22 cases,≥ 3 were 11 cases were statistically significant(2 = 9.48,P = 0.002);37 cases of positive SLN were detected in the ICG group,of which 26 cases were positive for SLN 1-2 and ≥ 3 were 11 cases after combined nano-carbonThe number of positive SLNs detected was 1-2 in 25 cases and ≥3 in 12 cases,which was statistically significant(2=4.70,P=0.03).Conclusion: The combination of nano-charcoal and ICG has advantages in the detection of axillary lymph node location in early breast cancer,and can detect more SLNs.The increased chance of detecting positive SLNs based on the increased number of detected SLNs can be achieved by using nano-carbon alone or When ICG is used as a tracer to detect positive SLNs 1-2,combined with another tracer is expected to increase the number of positive SLN detected to more than 3,increasing the accuracy of the assessment of axillary lymph node status,can be nano carbon and Indocyanine green is applied to the center of radionuclide deficiency. |
