论文部分内容阅读
目的:探讨核素示踪乳腺癌前哨淋巴结(SLN)活检的准确性和可行性。方法:1999年4月-2001年10月期间,应用原发肿瘤周围皮下注射放射性核素示踪技术(99mTC-标记硫化锑胶体或99mTC-标记硫胶体),对79例早期乳腺癌患者进行前哨淋巴结活检(SLND),随后,行包括腋窝淋巴结清扫(ALND)在内的根治性手术。分析评估两种核素淋巴示踪和SLND的准确性及其影响因素。结果:75例行术前淋巴闪烁照相,淋巴结显像67例(89.33%,67/75);术中应用γ探测仪成功证实SLNs 68例,成功率为86.08%(68/79),SLN预测腋窝淋巴结状态的准确性为95.59%(65/68),假阴性率为3/36(8.33%);前28例患者有9例不能证实SLN,3例假阴性;而后51例只有2例不能证实SLN,没有假阴性。两者差异有显著性(P<0.05)。结论:本研究结果表明,99mTC-标记硫胶体作为示踪剂,手术当天(术前4-6小时)乳腺肿瘤上方皮下注药进行SLND,可以准确预测早期乳腺癌腋窝淋巴结状态。
Objective: To investigate the accuracy and feasibility of nuclide tracing for sentinel lymph node (SLN) biopsy in breast cancer. METHODS: From April 1999 to October 2001, 79 patients with early-stage breast cancer were sent out using a subcutaneous radio-nuclide tracer technique (99mTC-labeled antimony sulfide or 99mTC-labeled sulfur colloid) Lymph node biopsy (SLND) followed by radical surgery including axillary lymph node dissection (ALND). Analyze and evaluate the accuracy of the two nuclide lymphatic tracings and SLND and their influencing factors. Results: There were 67 cases (89.33%, 67/75) with lymphoscintigraphy and lymph node imaging before operation in 75 cases. Sixty-eight SLNs were successfully proved by γ-detector during the operation. The success rate was 86.08% (68/79) The accuracy of axillary lymph node status was 95.59% (65/68) and the false negative rate was 3/36 (8.33%). The first 28 patients had 9 SLSLs and 3 false negatives. Only 51 of the 51 patients were unable to confirm SLN, no false negatives. The difference was significant (P <0.05). CONCLUSIONS: The results of this study indicate that 99mTC-labeled hypocrellin can be used as a tracer to SLND accurately on the day of surgery (4-6 hours before surgery) to accurately predict axillary lymph node status in early stage breast cancer.