摘要
目的:探讨用^(99m)Tc-硫胶体(^(99m)Tc-Sulfur colloid,SC)术前淋巴显像在乳腺癌前哨淋巴结活检(sentinel lymph node biopsy,SLNB)中的临床应用。方法:选择2009年7月到2010年1月本院收治的70例乳腺癌患者,于乳腺肿块周围3点、6点和12点位置各注射^(99m)Tc-Sc37MBq后15min、30min、1h、2h行前哨淋巴结(sentinel lymph node,SLN)显像,术中用γ探针探测"热点"淋巴结分析术前淋巴显像与术中探测检测乳腺癌SLNB的结果。结果:术前^(99m)Tc-Sc淋巴显像成功确定60例患者(85.71%)的前哨淋巴结,5例患者(7.15%)发现腋窝以外的前哨淋巴结。淋巴显像确定SLN的成功率与原发肿瘤病理类型、临床分期、肿瘤部位等因素无显著性相关(均P>0.05);与注射同位素到显像的时间有显著相关性(均P<0.05)。术中确定SLN的成功率在术前淋巴显像成功组与失败组之间有统计学差异(P<0.05)。结论:乳腺癌SLN术前淋巴显像在乳腺癌前哨淋巴结活检中具有一定临床价值,^(99m)Tc-Sc对乳腺癌前哨淋巴结检测具有较高的检出率和导向性,能较好的指导手术方案的制定,值得临床推广。
Objective： To explore the clinical value of ^99mTc-sulfur colloid （Sc） preoperative lymphoscintigraphy in senti- nel lymph node biopsy （SLNB） in breast cancer patients. Methods： Participants included 70 patients with breast cancer who underwent sentinel lymph node （SLN） detection with preoperative lymphoscintigraphy between July 2009 and January 2010. A dose of 37MBq ^99mTc-SC was hypodermically injected around the tumor at 3, 6 and 12 o＇clock positions on the breast. Lymphoscintigraphic images were taken at 15 min, 30 min, lh, and 2h after hypodermic injection. Intraoperative detection of ＂hot spot＂ lymph nodes was performed with a handheld gamma probe （γ-detection）. Data from the breast cancer patients who received consecutive preoperative lymphoscintigraphy before SLNB in our database were analyzed. Results： Sentinel lymph nodes （SLN） were well imaged by lymphoscintigraphy in 60 （85.71%） patients, and SLN were found in the extra-maxillary space in 5 patients （7.15%）. The success rate of SLNB in lymphoscintigraphy was not associated with histopathologic type or the stage and location of the primary tumor （P〉0.05）. However, the success rate of lymphoscintigraphy results was associated with the time interval between injection of radio colloid and surgery （P〈0.05）. The success rate of surgical identification of axillary SLN was associated with the imaging of hot spots by lymphoscintigraphy （P〈0.05）. Conclusion： Preoperative lymphoscintigraphy in SLNB in breast cancer patients has significant clinical value.^99mTc-SC has a better detection rate and guidance value in SLN detection of breast cancer. It is an effective guide for surgery and should be brought to the attention of clinicians.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2010年第21期1227-1231,共5页
Chinese Journal of Clinical Oncology
基金
中国临床早期乳腺癌前哨淋巴结活检替代腋窝淋巴结清扫术多中心研究项目资助(编号:CBCSG-001)~~
关键词
乳腺肿瘤
锝
硫胶体
淋巴显像
前哨淋巴结活检
Breast neoplasms
Technetium
Tc 99m sulfur colloid
Lymphoscintigraphy
Sentinel lymph node biopsy
