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中华乳腺病杂志(电子版) ›› 2026, Vol. 20 ›› Issue (05) : 279 -284. doi: 10.3877/cma.j.issn.1674-0807.2026.05.003

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乳腺癌前哨淋巴结示踪技术的研究进展
李玲1, 金锋1, 张殿龙2, 白石3, 陈波1,†()   
  1. 1 110001 沈阳,中国医科大学附属第一医院乳腺外科
    2 116001 大连,大连大学附属中山医院乳腺甲状腺外科
    3 110870 沈阳,沈阳工业大学信息科学与工程学院
  • 收稿日期:2026-04-15 出版日期:2026-10-01
  • 通信作者: 陈波

Sentinel lymph node tracing techniques for breast cancer

Ling Li1, Feng Jin1, Dianlong Zhang2, Shi Bai3, Bo Chen1,†()   

  1. 1 Department of Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang 110001, China
    2 Department of Breast and Thyroid Surgery, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, China
    3 School of Information Science and Engineering, Shenyang University of Technology, Shenyang 110870, China
  • Received:2026-04-15 Published:2026-10-01
  • Corresponding author: Bo Chen
引用本文:

李玲, 金锋, 张殿龙, 白石, 陈波. 乳腺癌前哨淋巴结示踪技术的研究进展[J/OL]. 中华乳腺病杂志(电子版), 2026, 20(05): 279-284.

Ling Li, Feng Jin, Dianlong Zhang, Shi Bai, Bo Chen. Sentinel lymph node tracing techniques for breast cancer[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2026, 20(05): 279-284.

前哨淋巴结活检是早期乳腺癌腋窝分期及降阶梯管理的重要手段,示踪技术的选择与优化直接影响前哨淋巴结检出率、假阴性风险和临床决策。目前,乳腺癌前哨淋巴结的示踪技术较多,主要包括蓝染料及可视染料、放射性核素、近红外荧光、磁性纳米颗粒示踪以及对比增强超声、多模态示踪等。这些示踪技术在临床中的应用存在差异。本文系统阐述示踪技术的研究进展,重点梳理不同示踪技术的原理、优势、局限和适用场景;结合中国乳腺外科实践,分析亚甲蓝、纳米炭、吲哚菁绿等高可及性或本土化方案的应用现状,并讨论新辅助治疗后患者的前哨淋巴结示踪策略。中国前哨淋巴结示踪技术的发展应兼顾循证证据和医疗资源差异,加强规范化培训、质量控制与多中心研究,推动适宜技术下沉和新技术转化,以推动乳腺癌腋窝管理向精准化、微创化和个体化方向发展。

Sentinel lymph node biopsy is important for axillary staging and de-escalated axillary management in early breast cancer. The selection and optimization of tracing techniques directly affect the sentinel lymph node detection rate, false-negative risk and clinical decision-making. Currently, there are many tracing techniques for sentinel lymph nodes in breast cancer, including blue and other visible dyes, radioactive tracers, near-infrared fluorescence, magnetic nanoparticle tracers, contrast-enhanced ultrasound and multimodal tracing. These tracing techniques vary in their clinical applications. This article reviews recent advances in sentinel lymph node tracing techniques for breast cancer, focusing on the principles, advantages, limitations and clinical applicability of each tracing technique. Based on breast surgery practice in China, this article analyzes the current application of tracers highly available or domestically developed in China, such as methylene blue, carbon nanoparticles and indocyanine green, and further discusses sentinel lymph node tracing strategies in patients who have received neoadjuvant therapy. In China, the development of SLN tracing techniques should take into account both the available evidence and the disparities in medical resources, strengthen standardized training, quality control, and multicenter studies, and promote both the dissemination of appropriate technologies to lower-tier institutions and the translation of new techniques, thereby advancing axillary management in breast cancer toward a more precise, minimally invasive, and individualized approach.

表1 乳腺癌前哨淋巴结示踪技术比较
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