Sentinel lymph node biopsy combined with fluorescence staining for detection of sentinel lymph node detection

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In recent years, sentinel lymph node biopsy has been used in the axillary lymph node staging of patients with breast cancer. At present, the

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In recent years, sentinel lymph node biopsy has been used in the axillary lymph node staging of patients with breast cancer. At present, the main methods used in the sentinel lymph node biopsy in the world are the staining method, the nuclide method and the combination of the two methods. However, radionuclide staining method to a certain extent has disadvantages, such as dyeing method the detection rate is low, there are statistics about 70-80%, and staining of sentinel lymph node biopsy technique requires a longer learning curve; and the radionuclide detection rate is high, but is known as nuclear radioactive pollution, and the equipment the demand is high, need special detectors, high costs, so can not be widely used in the domestic. At present, most of the hospitals in our country are the sentinel lymph node biopsy with the staining method as the main method, and the main method is to use the staining method as the sentinel lymph node biopsy.

Fluorescence method for sentinel lymph node biopsy technology is a new technology in recent years, there have been some reports, its detection rate in 87.5~100% (average 98.6%), the average can be detected in 3.4 lymph nodes, false negative rate is 7.7%. Its main advantage is to dynamically observe the fluorescence agent in lymphatic shape and location of sentinel nodes under direct vision, while the staining method can achieve.

Recently, general surgery department of the successful introduction of sentinel lymph node biopsy technique fluorescence method, succeeded in finding the sentinel lymph node using the method of double staining method combined with fluorescent tracer. Through clinical practice confirmed that the double tracer method combined with fluorescence staining of sentinel lymph node biopsy, and before the single dye tracing method, find the sentinel lymph node is more effective and accurate, and can save operation time, reduce the incidence of postoperative complications.

Figure 1: a special instrument for axillary sentinel lymph node fluorescence detector.

Figure 2 injection of indocyanine green (ICG) after about 10 minutes, using fluorescence detector in the image on the screen, can tube fluorescent agent flow path in the lymph clearly see, and stagnant near sentinel lymph node.

Figure three is the excision of the sentinel lymph node. The specimens were 1, 2, 3 sentinel lymph node Aizen right sentinel lymph node under the fluorescence probe instrument (1, 2, 3 in addition to the blue fluorescence of lymph nodes, 4, 6 non blue stained lymph nodes also fluorescence color), visible fluorescence method improves the detection rate of sentinel lymph node.

 

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