99Tcm-TMC与99Tcm-SC SPECT/CT探测乳腺癌前哨淋巴结的价值  

Value of 99Tcm-Tilmanocept and 99Tcm-sulfur colloid SPECT/CT for the detection of sentinel lymph node in breast cancer patients

作　　者：刘岩[1] 霍宗伟[2] 王晓慧[2] 孔琪[1] 任佳忠 杨国仁[2] 

机构地区：[1]济南大学、山东省医学科学院医学与生命科学学院,250022 [2]山东大学附属山东省肿瘤医院核医学科,济南250117

出　　处：《中华核医学与分子影像杂志》2017年第7期388-391,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的 通过比较99Tcm-TMC和99Tcm-SC对SLN探测结果,评估99Tcm-TMC 应用于术前SLN显像及术中SLN检出的临床价值.方法 前瞻性选取2016年3月至2016年9月山东省肿瘤医院乳腺外科收治的160例乳腺癌患者,年龄30-70岁,其中99Tcm-TMC显像76例（TMC组）,99Tcm-SC显像84例（SC组）,分别进行SLN平面显像与SPECT/CT显像结果的比较及SPECT/CT显像阳性率和手术检出率的比较.采用单因素方差分析、 χ2检验和两样本t检验分析数据.结果 99Tcm-TMC放化纯（≥92%）在4 h内无明显变化（F=0.720,P〉0.05）;TMC组SPECT/CT显像SLN平均数目[（1.34±0.64）枚]显著多于平面显像[（0.96±0.34）枚;t=4.556,P〈005];SC组SPECT/CT显像SLN平均数目[（2.57±0.99）枚]显著多于平面显像[（1.56±0.87）枚;t=7010,P〈0.05];TMC组和SC组SPECT/CT显像阳性率分别为94.7%（72/76）和96.4%（81/84）,差异无统计学意义（χ2=0.273, P〉005）.TMC组SPECT/CT显像SLN平均数目要显著少于SC组（t=9.115 ,P〈0.05）.TMC组与SC组患者术中SLN检出率均为100%（76/76和84/84）,TMC组术中探查SLN平均数目[（1.89±0.86）枚]显著少于SC组[（3.05±1.29）枚;t=6.642,P〈0.01].TMC组术中检出SLN平均数目[（1.89±0.86）枚]显著多于SPECT/CT显像[（1.34±0.64）枚;t=4.492,P〈0.05];SC组术中检出SLN平均数目[（3.05±1.29）枚]显著多于SPECT/CT显像[（2.57±0.99）枚;t=2.740,P〈0.05].结论 SPECT/CT显像在SLN显像数量及定位准确性方面均优于平面显像,99Tcm-TMC可应用于临床乳腺癌患者SLN显像和术中探查.Objective To evaluate the clinical value of 99Tcm-Tilmanocept（TMC） SPECT/CT for the detection of SLN by comparing with 99Tcm-sulfur colloid（SC） SPECT/CT. Methods From March 2016 to September 2016, a total of 160 patients （age range： 30-70 years）, selected from Breast Surgery Department of Shandong Cancer Hospital, underwent SPECT/CT and planar imaging with either 99Tcm-TMC （TMC group, n=76） or 99Tcm-SC （SC group, n=84）. The results of SLN SPECT/CT and planar imaging were compared. The positive rate of SLN in SPECT/CT was compared with operative results. One-way analysis of variance, χ2 test, and two-sample t test were used for data analysis. Results The radiochemical purity of 99Tcm-TMC （≥92%） had no significant difference in 4 h（F=0.720, P〉0.05）. In TMC group, the average number of SLN detected by SPECT/CT imaging was higher than that by planar imaging （1.34±0.64 vs 0.96±034; t=4556, P〈005）. In SC group, the average number of SLN detected by SPECT/CT imaging was also higher than that by planar imaging （2.57±0.99 vs 1.56±0.87; t=7.010, P〈0.05）. The positive rates of SLN in TMC and SC groups were 94.7%（72/76）and 96.4%（81/84）, showing no significant difference （χ2=0273, P〉0.05）. The average number of SLN detected by 99Tcm-TMC imaging was significantly lower than that detected by 99Tcm-SC （t=9.115, P〈0.05）. The intraoperative detection rates of SLN were 100% （76/76 and 84/84） in both groups. The average number of SLN detected during operation in TMC group was significantly lower than that in SC group （1.89±0.86 vs 3.05±1.29; t=6.642, P〈0.01）. In TMC group, the average number of SLN detected during operation was significantly higher than that detected by SPECT/CT（1.89±086 vs 1.34±0.64; t=4.492, P〈0.05）. In SC group, the average number of SLN detected during operation was significantly higher than that detected by SPECT/CT（3.05±1.29 vs 2.57±0.99; t=2.740, P〈005）. Conclusions SPECT/CT is superior to pla

关 键 词：乳腺肿瘤 前哨淋巴结 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 甘露糖苷类 99m锝硫胶 

分 类 号：R730.44[医药卫生—肿瘤]