
浏览全部资源
扫码关注微信
1. 复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海 200032
2. 中国上海肿瘤医学协同创新中心,上海 200032
3. 郑州大学附属肿瘤医院,河南省肿瘤医院乳腺科,河南 郑州 450003
4. 山东省肿瘤医院乳腺外科,山东 济南 250117
5. 浙江大学医学院附属邵逸夫医院肿瘤外科,浙江 杭州 310016
6. 青岛大学附属医院乳腺外科,山东 青岛 266000
7. 大连医科大学附属第二医院乳腺外科,辽宁 大连 116021
8. 吉林大学白求恩第一医院乳腺外科,吉林 长春 130021
9. 沈阳药科大学药学院药剂学系,辽宁 沈阳 110016
[ "杨犇龙(ORCID: 0000-0003-1343-728X),博士,副主任医师。" ]
刘真真(ORCID: 0000-0002-3878-1258),博士,主任医师,郑州大学附属肿瘤医院乳腺科主任。
王永胜(ORCID: 0000-0001-6252-684X),博士,主任医师,山东省肿瘤医院乳腺病中心主任;
[ "吴炅,主任医师,教授,博士研究生导师,复旦大学附属肿瘤医院副院长,药物临床试验机构主任。学术任职包括:中国抗癌协会乳腺癌专业委员会主任委员,中国医师协会外科医师分会乳腺外科医师专业委员会副主任委员,中国医师协会肿瘤医师分会副主任委员,中华医学会肿瘤学分会常委,中华医学会外科分会乳腺外科学组副组长,上海市医学会肿瘤分会候任主委,上海市抗癌协会乳腺癌专业委员会荣誉主任委员,上海市医学会肿瘤靶分子专科分会前任主任委员。擅长乳腺癌的综合治疗,特别是新的外科诊疗技术在乳腺疾病中的应用,包括乳腺癌保乳手术、乳腺癌前哨淋巴结活检、乳腺癌一期乳房重建手术。作为一期临床研究负责人,牵头主持8项抗肿瘤新药Ⅰ期注册研究。主持编撰了《乳腺肿瘤整形与乳房重建专家共识(2018年版)》、《乳腺肿瘤整形与乳房重建专家共识(2022年版)》和《保留乳房治疗专家共识(2020年版)》,并连续12年主办上海市乳房重建论坛。以第一作者及通信作者在SCI收录期刊上发表论文70余篇;主编《乳腺癌术后乳房重建》、《乳腺癌的乳房重建手术》、Reconstruction Surgery in Breast Cancer,参编《现代乳腺肿瘤学进展》、《肿瘤外科手术学》、《乳腺肿瘤学》等专著。曾被授予上海市卫生局首批“医苑新星”、上海市卫生局先进工作者、复旦大学“世纪之星”,获得上海市科技启明星、上海市教委曙光计划、上海市科委优秀学术带头人计划等人才基金。目前承担国家重大慢病非传染性疾病防控研究课题及国家自然科学基金面上项目等。2004年以第三完成人获国家科技进步二等奖(乳腺癌的临床和基础研究),并多次以主要完成人获得多项上海市科技进步奖;以第一完成人获得上海市临床医学成果奖。" ]
收稿:2022-12-27,
修回:2023-02-03,
纸质出版:2023-02-28
移动端阅览
杨犇龙, 焦得闯, 陈嘉健, 等. 示踪用盐酸米托蒽醌注射液与核素用于乳腺癌前哨淋巴结活检的疗效对比研究[J]. 中国癌症杂志, 2023,33(2):126-133.
Benlong YANG, Dechuang JIAO, Jiajian CHEN, et al. Compared the efficacy of mitoxantrone hydrochloride injection for tracing with radionuclide in sentinel lymph node biopsy of breast cancer[J]. China Oncology, 2023, 33(2): 126-133.
杨犇龙, 焦得闯, 陈嘉健, 等. 示踪用盐酸米托蒽醌注射液与核素用于乳腺癌前哨淋巴结活检的疗效对比研究[J]. 中国癌症杂志, 2023,33(2):126-133. DOI: 10.19401/j.cnki.1007-3639.2023.02.005.
Benlong YANG, Dechuang JIAO, Jiajian CHEN, et al. Compared the efficacy of mitoxantrone hydrochloride injection for tracing with radionuclide in sentinel lymph node biopsy of breast cancer[J]. China Oncology, 2023, 33(2): 126-133. DOI: 10.19401/j.cnki.1007-3639.2023.02.005.
背景与目的:
国内外指南均推荐核素用作前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)示踪剂,但多种原因导致该技术在国内未得到普及。示踪用盐酸米托蒽醌注射液(mitoxantrone hydrochloride injection for tracing,MHI)是一种新型乳腺癌前哨淋巴结(sentinel lymph node,SLN)示踪剂,其在乳腺癌SLNB中的效果尚未明确。本研究是一项大样本阳性对照临床试验,旨在评价MHI和核素在SLNB中的示踪差异。
方法:
试验纳入了2019年12月—2020年7家医院的早期乳腺癌患者。所有入组的早期乳腺癌患者均在手术前注射MHI和核素作为SLN示踪剂。分别统计MHI和核素的SLN检出数量和SLN检出率,分析两种示踪剂示踪效果的差异。
结果:
MHI的SLN检出率为96.9%(370/382),核素的SLN检出率为97.4%(372/382),两者检出率差异无统计学意义(
P
>
0.05)。两种示踪剂共同检测到362例(94.7%)受试者的SLN;16例(4.1%)发生可能与试验药物相关的不良事件。
结论:
本研究发现MHI示踪效果不劣于核素。且MHI的使用无需特殊仪器/设备辅助。
Background and purpose:
Both domestic and foreign guidelines recommend the use of radionuclide as sentinel lymph node (SLN) biopsy (SLNB) tracer
however this technique has not been popularized in China for a variety of reasons. Mitoxantrone hydrochloride injection for tracing (MHI)
a new strategy to identify lymph nodes
has not been tested for axillary node staging in breast cancer. This multicenter
self-controlled
non-inferiority trial aimed to evaluate the differences between MHI and radionuclide in SLNB tracing.
Methods:
T
he trial was conducted across 7 hospitals from December 2019 to December 2020. Patients with early-stage breast cancer received MHI and radionuclide (technetium 99 labeled sulfur colloid
99m
Tc-Sc) as SLN tracers during the surgery. The number of SLNs detected and sentinel node detection rates of MHI and radionuclide were counted to evaluate differences in the tracing effects between the two tracers.
Results:
SLN detection rates of MHI and radionuclide were 96.9% (370/382) and 97.4% (372/382)
respectively
with no significant difference (
P
>
0.05). SLNs were co-detected by both tracers in 362 (94.7%) patients; 16 (4.1%) had adverse events possibly related to the trial drugs.
Conclusion:
In this study
it was found that the lymphatic tracing ability of MHI was not inferior to that of radionuclide. Meanwhile
the use of MHI does not require special instrument/equipment assistance.
SUNG H , FERLAY J , SIEGEL R L , et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2021 , 71 ( 3 ): 209 - 249 . DOI: 10.3322/caac.v71.3 http://doi.org/10.3322/caac.v71.3 https://onlinelibrary.wiley.com/toc/15424863/71/3 https://onlinelibrary.wiley.com/toc/15424863/71/3
张雅聪 , 吕章艳 , 宋方方 , 等 . 全球及我国乳腺癌发病和死亡变化趋势 [J ] . 肿瘤综合治疗电子杂志 , 2021 , 7 ( 2 ): 14 - 20 .
ZHANG Y C , LYU Z Y , SONG F F , et al. Trends of incidence and mortality of breast cancer worldwide and in China [J ] . J Multidiscip Cancer Manag Electron Version , 2021 , 7 ( 2 ): 14 - 20 .
VERONESI U , PAGANELLI G , VIALE G , et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer [J ] . N Engl J Med , 2003 , 349 ( 6 ): 546 - 553 . DOI: 10.1056/NEJMoa012782 http://doi.org/10.1056/NEJMoa012782 http://www.nejm.org/doi/abs/10.1056/NEJMoa012782 http://www.nejm.org/doi/abs/10.1056/NEJMoa012782
KIM T , GIULIANO A E , LYMAN G H . Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a meta analysis [J ] . Cancer , 2006 , 106 ( 1 ): 4 - 16 . DOI: 10.1002/(ISSN)1097-0142 http://doi.org/10.1002/(ISSN)1097-0142 http://doi.wiley.com/10.1002/%28ISSN%291097-0142 http://doi.wiley.com/10.1002/%28ISSN%291097-0142
GIULIANO A E , HUNT K K , BALLMAN K V , et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial [J ] . JAMA , 2011 , 305 ( 6 ): 569 - 575 . DOI: 10.1001/jama.2011.90 http://doi.org/10.1001/jama.2011.90
YANG B L , REN G S , SONG E W , et al. Current status and factors influencing surgical options for breast cancer in China: a nationwide cross-sectional survey of 110 hospitals [J ] . Oncologist , 2020 , 25 ( 10 ): e1473 -e1480. DOI: 10.1634/theoncologist.2020-0001 http://doi.org/10.1634/theoncologist.2020-0001 https://academic.oup.com/oncolo/article/25/10/e1473/6443837 https://academic.oup.com/oncolo/article/25/10/e1473/6443837
TAGAYA N , TSUMURAYA M , NAKAGAWA A , et al. Indocyanine green (ICG) fluorescence imaging versus radioactive colloid for sentinel lymph node identification in patients with breast cancer [J ] . J Clin Oncol , 2010 , 28 ( 15_suppl ): 674 . DOI: 10.1200/jco.2010.28.15_suppl.674 http://doi.org/10.1200/jco.2010.28.15_suppl.674 http://ascopubs.org/doi/10.1200/jco.2010.28.15_suppl.674 http://ascopubs.org/doi/10.1200/jco.2010.28.15_suppl.674
KARAKATSANIS A , CHRISTIANSEN P M , FISCHER L , et al. The Nordic SentiMag trial: a comparison of super paramagnetic iron oxide (SPIO) nanoparticles versus Tc(99) and patent blue in the detection of sentinel node (SN) in patients with breast cancer and a meta-analysis of earlier studies [J ] . Breast Cancer Res Treat , 2016 , 157 ( 2 ): 281 - 294 . DOI: 10.1007/s10549-016-3809-9 http://doi.org/10.1007/s10549-016-3809-9 http://link.springer.com/10.1007/s10549-016-3809-9 http://link.springer.com/10.1007/s10549-016-3809-9
KITAI T , INOMOTO T , MIWA M , et al. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer [J ] . Breast Cancer , 2005 , 12 ( 3 ): 211 - 215 . DOI: 10.2325/jbcs.12.211 http://doi.org/10.2325/jbcs.12.211 http://link.springer.com/10.2325/jbcs.12.211 http://link.springer.com/10.2325/jbcs.12.211
RUBIO I T , DIAZ-BOTERO S , ESGUEVA A , et al. The superparamagnetic iron oxide is equivalent to the Tc99 radiotracer method for identifying the sentinel lymph node in breast cancer [J ] . Eur J Surg Oncol , 2015 , 41 ( 1 ): 46 - 51 . DOI: 10.1016/j.ejso.2014.11.006 http://doi.org/10.1016/j.ejso.2014.11.006
MAO Y L , LIU J , SHI T Y , et al. A novel self-assembly nanocrystal as lymph node-targeting delivery system: higher activity of lymph node targeting and longer efficacy against lymphatic metastasis [J ] . AAPS PharmSciTech , 2019 , 20 ( 7 ): 292 . DOI: 10.1208/s12249-019-1447-3 http://doi.org/10.1208/s12249-019-1447-3
陈少博 , 刘玮楠 , 张圣洁 , 等 . 示踪用盐酸米托蒽醌注射液用于甲状腺癌前哨淋巴结示踪的临床疗效、安全性及药代动力学Ⅰ期试验 [J ] . 协和医学杂志 , 2021 , 12 ( 5 ): 729 - 735 .
CHEN S B , LIU W N , ZHANG S J , et al. Clinical efficacy, safety and pharmacokinetics of tracing injection of mitoxantrone hydrochloride for tracing sentinel lymph nodes in thyroid carcinoma: a phase Ⅰ clinical trial [J ] . Med J Peking Union Med Coll Hosp , 2021 , 12 ( 5 ): 729 - 735 .
YANG B L , ZHENG S Y , HUANG X Y , et al. A single-center, self-controlled, phase Ⅰ clinical trial of mitoxantrone hydrochloride injection for lymph tracing for sentinel lymph node identification of breast cancer [J ] . Gland Surg , 2021 , 10 ( 3 ): 992 - 1001 . DOI: 10.21037/gs http://doi.org/10.21037/gs http://gs.amegroups.com http://gs.amegroups.com
CLOPPER C J , PEARSON E S . The use of confidence or fiducial limits illustrated in the case of the binomial [J ] . Biometrika , 1934 , 26 ( 4 ): 404 - 413 . DOI: 10.1093/biomet/26.4.404 http://doi.org/10.1093/biomet/26.4.404 https://academic.oup.com/biomet/article-lookup/doi/10.1093/biomet/26.4.404 https://academic.oup.com/biomet/article-lookup/doi/10.1093/biomet/26.4.404
刘玉秀 , 徐晓莉 , 郑均 . 配对二项数据等效性/非劣效性评价的样本含量估计和假设检验 [J ] . 中国临床药理学与治疗学 , 2008 , 13 ( 3 ): 299 - 302 .
LIU Y X , XU X L , ZHENG J . Sample size estimation and hypothesis testing of assessing equivalence/noninferiority for paired binary data [J ] . Chin J Clin Pharmacol Ther , 2008 , 13 ( 3 ): 299 - 302 .
LI J Y , CHEN X , QI M , et al. Sentinel lymph node biopsy mapped with methylene blue dye alone in patients with breast cancer: a systematic review and meta-analysis [J ] . PLoS One , 2018 , 13 ( 9 ): e0204364 . DOI: 10.1371/journal.pone.0204364 http://doi.org/10.1371/journal.pone.0204364 https://dx.plos.org/10.1371/journal.pone.0204364 https://dx.plos.org/10.1371/journal.pone.0204364
VIDYA R , ATHWAL R , HUISSOON A P , et al. Diagnostic application of patent blue V in sentinel lymph node biopsy for breast cancer-is it time for a change? [J ] . Indian J Cancer , 2019 , 56 ( 3 ): 269 - 270 . DOI: 10.4103/ijc.IJC_139_18 http://doi.org/10.4103/ijc.IJC_139_18 http://www.indianjcancer.com/text.asp?2019/56/3/269/263026 http://www.indianjcancer.com/text.asp?2019/56/3/269/263026
GUO J J , YANG H P , WANG S , et al. Comparison of sentinel lymph node biopsy guided by indocyanine green, blue dye, and their combination in breast cancer patients: a prospective cohort study [J ] . World J Surg Oncol , 2017 , 15 ( 1 ): 196 . DOI: 10.1186/s12957-017-1264-7 http://doi.org/10.1186/s12957-017-1264-7
LEE J H , CHANG C H , PARK C H , et al. Methylene blue dye-induced skin necrosis in immediate breast reconstruction: evaluation and management [J ] . Arch Plast Surg , 2014 , 41 ( 3 ): 258 - 263 . DOI: 10.5999/aps.2014.41.3.258 http://doi.org/10.5999/aps.2014.41.3.258
PEEK M C , CHARALAMPOUDIS P , ANNINGA B , et al. Blue dye for identification of sentinel nodes in breast cancer and malignant melanoma: a systematic review and meta-analysis [J ] . Future Oncol , 2017 , 13 ( 5 ): 455 - 467 . DOI: 10.2217/fon-2016-0255 http://doi.org/10.2217/fon-2016-0255
CROSSLEY R J . Clinical safety and tolerance of mitoxantrone [J ] . Semin Oncol , 1984 , 11 (3 Suppl 1 ): 54 - 58 .
0
浏览量
2766
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621