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首页> 外文期刊>Annals of surgical oncology >Prospective randomized clinical trial comparing intradermal, intraparenchymal, and subareolar injection routes for sentinel lymph node mapping and biopsy in breast cancer.
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Prospective randomized clinical trial comparing intradermal, intraparenchymal, and subareolar injection routes for sentinel lymph node mapping and biopsy in breast cancer.

机译：前瞻性随机临床试验比较了皮内，实质内和乳晕下注射途径对乳腺癌前哨淋巴结的定位和活检。

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BACKGROUND: Multiple injection routes, including intradermal (ID), intraparenchymal (IP), and subareolar (SA), are used for 99mTc-sulfur colloid administration for sentinel lymph node (SLN) mapping and biopsy in breast cancer. The aim of this study was to compare localization by ID, IP, and SA injection routes based on preoperative lymphoscintigraphy and intraoperative identification. METHODS: Four hundred prospectively randomized breast cancers underwent SLN mapping and biopsy. RESULTS: Preoperative lymphoscintigraphy demonstrated localization to the axilla in 126/133 (95%) ID, 82/132 (62%) IP, and 96/133 (72%) SA (P < 0.001 ID vs. IP and ID vs. SA; P = 0.081 IP vs. SA), with a mean duration of preoperative lymphoscintigraphy of 139 +/- 18 minutes. Mean time to first localization when localization was demonstrated on preoperative lymphoscintigraphy was 8 +/- 14 minutes for ID, 53 +/- 49 for IP, and 22 +/- 29 for SA (P < 0.001 ID vs. IP and ID vs. SA; P = 0.003 IP vs. SA). Intraoperative identificationof a SLN at the time of SLN biopsy was successful in 133/133 (100%) ID, 121/134 (90%) IP, and 126/133 (95%) SA (P < 0.001 ID vs IP; P = 0.014 ID vs. SA; P = 0.168 IP vs. SA), with a mean time from injection of 99mTc-sulfur colloid to start of SLN biopsy of 288 +/- 71 minutes. Mean intraoperative time to harvest the first SLN was 9 +/- 4 minutes for ID, 13 +/- 6 for IP, and 12 +/- 6 for SA (P < 0.001 ID vs. IP and ID vs. SA; P = 0.410 IP vs. SA). CONCLUSIONS: The ID injection route demonstrated a significantly greater frequency of localization, decreased time to first localization on preoperative lymphoscintigraphy, and decreased time to harvest the first SLN. This represents the first prospective randomized clinical trial to confirm superiority of the ID route for administration of 99mTc-sulfur colloid during SLN mapping and biopsy in breast cancer.
机译：背景：多种注射途径，包括真皮内（ID），实质内（IP）和乳晕下（SA），用于99mTc-硫胶体给药，用于乳腺癌前哨淋巴结（SLN）定位和活检。这项研究的目的是比较基于术前淋巴造影和术中鉴定的ID，IP和SA注射途径的定位。方法：对400例前瞻性随机乳腺癌进行了SLN定位和活检。结果：术前淋巴造影显示在126/133（95％）ID，82/132（62％）IP和96/133（72％）SA中定位于腋窝（P <0.001 ID vs.IP和ID vs.SA ; P = 0.081 IP vs. SA），术前平均淋巴造影时间为139 +/- 18分钟。术前淋巴闪烁显像时首次定位的平均时间为ID：8 +/- 14分钟; IP：53 +/- 49分钟; SA：22 +/- 29分钟（P <0.001 ID vs. IP和ID vs. IP。 SA; P = 0.003 IP vs. SA）。在SLN活检时，术中SLN的鉴定成功于133/133（100％）ID，121/134（90％）IP和126/133（95％）SA（P <0.001 ID vs IP; P = 0.014 ID vs. SA; P = 0.168 IP vs. SA），从注射99mTc-硫胶体到开始SLN活检的平均时间为288 +/- 71分钟。 ID的平均术中时间为9 +/- 4分钟，ID的平均术中时间为13 +/- 6分钟，SA的平均术中时间为12 +/- 6分钟（P <0.001 ID vs. IP和ID vs. SA; P = 0.410 IP与SA）。结论：ID注射途径表现出明显更高的定位频率，术前淋巴闪烁显像术首次定位的时间减少，以及收集首个SLN的时间减少。这代表了第一个前瞻性随机临床试验，该试验证实了IDL途径在乳腺癌SLN定位和活检过程中给予99mTc-硫胶体的优越性。

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