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目的探讨非小细胞肺癌术中应用99mTc探测肺癌前哨淋巴结,以提高术中清除前哨淋巴结的准确性。方法 30例非小细胞肺癌患者,术中将99mTc硫胶体溶液在肺部肿瘤环周的4～6个部位分别注射,用便携式γ射线探测器探测肺门及纵隔各部位淋巴结的放射活性计数值。常规行肺癌肺叶切除、淋巴结清除术并行常规病理检查。结果 30例患者共清除淋巴结395枚,其中前哨淋巴结即阳性转移淋巴结112枚,阳性转移率为28.3%。前哨淋巴结的99mTc放射活性计数值为15321.85±5945.28,阴性淋巴结的计数值为8479.26±3201.37(P<0.01)。结论对于非小细胞肺癌患者,术中应用99mTc标记前哨淋巴结能够更准确地提示肺癌纵隔转移淋巴结,有效提高转移淋巴结的检出率。
Objective To investigate the application of 99mTc in the detection of sentinel lymph node in non-small cell lung cancer and to improve the accuracy of removing sentinel lymph nodes. Methods Thirty patients with non-small cell lung cancer were treated with 99mTc sulfur colloidal solution in 4 ~ 6 sites around the lung tumor during operation, respectively. The radioactivity counts of hilar and mediastinal lymph nodes were measured by portable γ-ray detector . Conventional lung cancer lobectomy, lymph node dissection and routine pathological examination. Results A total of 395 lymph nodes were removed in 30 patients, of which 112 sentinel lymph nodes were positive, with a positive rate of 28.3%. The sentinel lymph node 99mTc radioactivity count was 15321.85 ± 5945.28, and the negative lymph node count was 8479.26 ± 3201.37 (P <0.01). Conclusion For patients with non-small cell lung cancer, the application of 99mTc labeled SLN can prompt the mediastinal lymph node metastasis of lung cancer more accurately and effectively increase the detection rate of metastatic lymph nodes.