核素法前哨淋巴通道的研究  

Study of sentinel lymphatic channels by using technetium 99m sulfur colloid in breast cancer patients

作　　者：凌立君[1] 赵佳[1] 王水[1] 刘晓安[1] 

机构地区：[1]南京医科大学第一附属医院普外科乳腺内分泌病区,210029

出　　处：《中华乳腺病杂志（电子版）》2007年第2期16-18,共3页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：江苏省科技发展计划(社会发展)基金资助项目(BS2004040);江苏省135工程(RC2002059);江苏省博士后基金(0601048B)

摘　　要：目的探讨前哨淋巴通道(SLCs)的行走方向、途径、数量及其与前哨淋巴结(SLN)之间的关系。方法对91例Ⅰ～Ⅱ期乳腺癌患者行术前淋巴显像,其中成功显示SLCs者79例,测量并记录SLCs的外侧角即θe。结果 93.67%(n=74)的病例有一条主要的SLC,6.33%(n=5)的病例有两条SLCs。SLCs主要走行在乳腺的外上象限(n=78,占98.73%),其中5例(6.33%)SLCs的θe角为0°～30°,28例(35.44%)SLCs的θe角为31°～60°,45例(56.96%)θe角为61°～90°,均终止于腋窝SLNs,未发现有内乳区SLNs。结论通过乳晕下注射^(99)Tc^m-SC行术前淋巴显像,显示SLCs主要起源于乳晕的外上边缘,穿越乳腺的外上象限,终止于腋窝SLNs。通过术前对SLCs和SLN行走路线和数量的认识有助于手术医生在术中正确定位SLN,提高SLNB的检出率、减少假阴性率。Objective To explore the direction, route and number of SLCs （Sentinel Lymphatic Channels ） and their relationship with SLNs by using subareolar injection of technetium 99m sulfur colloid （^99Tc^m-SC）. Methods Lymphoscintigraphy was performed in 91 breast cancer cases of stages Ⅰ-Ⅱ, and SLCs were identified successfully in 79 cases, in which the exit angle （ θe ） was tested. Results One SLC was identified in 74 cases, holding 93.67% and two SLCs were identified in 5 cases, holding 6.33%. And 6.33% of SLCs exited the areola with θe =0°-30°（ n =5）, 35.44% exited the areola with θe = 31° -60°（ n =28） ,and 56.96% exited the areola with θe = 61° - 90° （ n = 45） ; 98.73% of SLCs traveled through the upper, outer quadrant （ n = 78）, and terminated at an axillary SLN. No false negative or false positive was demonstrated by pathological analysis of SLNs which were identified according to SLCs. Conclusions Most SLCs exit the areola, traveled through the upper, outer quadrant and terminate at axillary SLNs. By using subareolar injection of ^99Tc^m-SC, SLCs and SLNs can be identified preoperatively and dissected carefully during operation. The detection rate of SLCs can be improved and the false negative rate of SLNB can be reduced.

关 键 词：乳腺癌 前哨淋巴结活检 前哨淋巴通道 核素 

分 类 号：R737.9[医药卫生—肿瘤]