核素法导航乳腺癌前哨淋巴结不同部位注射的临床对比分析  

Subareolar versus peritumoral injection for location of sentinel lymph node in breast carcinoma

作　　者：盛宇伟[1] 任建强[2] 胡蓉[1] 周予民[1] 

机构地区：[1]上海交通大学附属上海市第一人民医院宝山分部,200940 [2]上海交通大学附属上海市第一人民医院

出　　处：《临床外科杂志》2008年第7期454-456,共3页Journal of Clinical Surgery

摘　　要：目的探讨将示踪剂行乳晕下注射与肿瘤周围注射检测乳腺癌前哨淋巴结(SLN)的可行性及准确性。方法36例临床上腋窝淋巴结阴性的乳腺癌,术前18例患者于乳晕下注射1.0mCi的99mTc硫化胶体,另18例患者于肿瘤周围注射1.0mCi的99mTc硫化胶体,两组术中用手握式同位素探测仪确认有放射活性的SLN,行手术解剖出SLN,所取SLN单独送病检,相应腋窝行淋巴结清扫并常规病检。结果18例乳晕下注射发现SLN者17例,每例SLN平均数目为(1.3±0.7)枚,检出率为94.4%,SLN病检结果预测淋巴结的准确率为94.1%,假阴性1例,假阴性率为5.9%,18例肿瘤周围注射法的患者中发现SLN者16例,每例SLN平均为(2.1±0.9)枚,检出率为88.9%,SLN病检结果预测淋巴结的准确率为87.5%,2例假阴性,假阴性率为12.5%。结论核素法导航定位乳腺癌SLN能准确反映区域淋巴结的转移情况,同时乳晕下注射法比肿瘤周围注射法确定SLN有更高的准确性。Objective To investigate the possibility and accuracy of identification of the sentinel lymph node （SLN） in breast carcinoma through subareolar versus peritumoral injection by radioactive tracing marker, Methods Of 36 patients with operable invasive breast carcinomas and clinically node -negative, 18 cases were subjected to subareolar injection of 1.0 mCi technetium -99 sulfur colloid before operation,and the remaining 18 cases to peritumor injection of 1, 0 mCi technetium - 99 sulfur colloid respectively, Radioactive SLNs were identified using a hand - held gamma detector probe and removed during operation, All SLNs were examined for pathology separately and all patients had axillary lymphadenectomy and routinely pathological examination. Results SLNs were identified in 17 of 18 patients through subareolar injection, with an average of （1.3 ± 0. 7 ） SLNs and identifying rate was 94.4%, Histologic status of SLNs predicted axillary nodes status with an accuracy rate of 94.1% and false negative rate of 5.9% （1 case）, The SLNs were identified in 16 of 18 patients through peritumoral injection,with an average of （2.1 ±0.9） SLNs and identifying rate was of 88.9%, Histologie status of SLNs predicted axillary nodes status with an accuracy rate of 87.5% and false negative rate of 12, 5% （2 cases）. Conclusion SLNs in breast carcinomas detected by radioactive tracing marker is able to predict regional lymph node metastasis, Subareolar injection is more accurate than peritumoral injection.

关 键 词：乳腺癌 前哨淋巴结 示踪剂 

分 类 号：R737.9[医药卫生—肿瘤]