前哨淋巴结核素显像在早期宫颈癌盆腔淋巴结清除术中的初步应用  

Nuclide Imaging of Sentinel Lymph Node for the Pelvic Lymph Nodes' Elimination of Early Cervix Cancer

作　　者：李艳梅[1] 高沁怡[1] 郭科军[2] 温放[2] 李亚明[1] 王玉华[1] 

机构地区：[1]中国医科大学附属第一医院核医学科,辽宁沈阳110001 [2]中国医科大学附属第一医院妇科,辽宁沈阳110001

出　　处：《同位素》2009年第1期14-17,64,共5页Journal of Isotopes

摘　　要：通过在早期宫颈癌治疗中应用核素淋巴结显像确定前哨淋巴结(SLN),探讨其在盆腔淋巴结清除术中的价值。对15例宫颈癌患者先行核素淋巴显像,18 h内行宫颈癌根治性子宫切除术及盆腔淋巴结清除术,用γ探测器找出比周围放射性计数高出10倍以上的区域即为前哨淋巴结区,并将该区的前哨淋巴结与非前哨淋巴结做HE染色并进行统计。结果显示,15例病人中14例检出SLN,占93.3%,共取得淋巴结217枚,其中SLN18枚;术后经病理证实1枚SLN确诊为淋巴结转移,其余17枚为阴性SLN,再行免疫组化均为阴性。其灵敏度为100%,准确度为92.9%,阴性预测值为100%,假阴性率为0。以上结果表明,前哨淋巴结核素显像对早期宫颈癌淋巴结清除术具有一定的指导价值。The clinical value of sentinel lymph node （SLN） detected by nuclide lymph imaging in clearance for pelvic lymph nodes of early cervix carcinoma were observed. Firstly fifteen cases of patients with cervix carcinoma were carried out with the nuclide lymph imaging and radical hysterectomy for cancer of cervix and clearance of pelvic lymph nodes within later eighteen hours. SLN area were find out that the radioactivity counts was above ten times higher than that of surrounding lymph nodes area. Then statistics of SLN and NSLN with HE were made. The results showed that SLNs were identified in 14 of 15 patients （93.3%）. A total of 217 lymph nodes were adopted from 15 patients, among which 18 lymph nodes were identified as SLNs, and one of the lymph nodes was confirmed by pathology, the remaining seventeen SLNs were negative lymph nodes, which were still negative in immunohistochemistry examination. The sensitivity was 100%, the accuracy was 92.9%, the negative predictive value was 100%, and the false negative rate was 0. The results demonstrated that nuclide lymph imaging possessed a certain guiding value in clearance of lymph nodes of early cervical cancer.

关 键 词：^99Tc-右旋糖苷 早期宫颈癌 核素淋巴结显像 前哨淋巴结 

分 类 号：R814.43[医药卫生—影像医学与核医学] R711.74[医药卫生—放射医学]