^(99)Tc^(m)-利妥昔单抗SPECT/CT乳腺癌前哨淋巴结显像的临床评价  

Clinical evaluation of ^(99)Tc^(m)-Rituximab SPECT/CT sentinel lymph node imaging in breast cancer

作　　者：林秀艳 于丽娟 熊亮 蒋海壮 王玉君 李雪艳 Lin Xiuyan;Yu Lijuan;Xiong Liang;Jiang Haizhuang;Wang Yujun;Li Xueyan(Department of Nuclear Medicine,Hainan Cancer Hospital,the Affiliated Cancer Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]海南省肿瘤医院(海南医学院附属肿瘤医院)核医学科,海口570311

出　　处：《国际放射医学核医学杂志》2021年第7期411-415,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨^(99)Tc^(m)-利妥昔单抗(^(99)Tc^(m)-Rituximab)SPECT/CT对乳腺癌前哨淋巴结(SLN)的诊断效能。方法回顾性分析2019年7月至2020年7月于海南省肿瘤医院经组织病理学检查证实的22例女性乳腺癌患者的临床资料,患者年龄37~73岁(中位年龄50.5岁)。所有患者术前均行^(99)Tc^(m)-利妥昔单抗SPECT/CT显像,分析图像并统计SLN的数量。显像后1~2 h进行手术,术中采用便携式γ探测器探测SLN,以术中检出的SLN数量为"金标准",评估^(99)Tc^(m)-利妥昔单抗SPECT/CT的诊断效能。结果^(99)Tc^(m)-利妥昔单抗SPECT/CT显像共检出SLN 67枚,以1~3枚者居多(68%,15/22),术中γ探测器共检出SLN 81枚,以2~4枚者居多(73%,16/22)。以患者为单位,^(99)Tc^(m)-利妥昔单抗显像的灵敏度为100%(22/22)、总符合率为100%(22/22);以淋巴结为单位,灵敏度为83%(67/81)、阳性预测值为100%(67/67)、总符合率为83%(67/81)。结论^(99)Tc^(m)-利妥昔单抗SPECT/CT对乳腺癌SLN的诊断灵敏度及符合率高,具有较好的临床应用性。Objective To explore the diagnostic efficiency of ^(99)Tc^(m)-Rituximab SPECT/CT for sentinel lymph node(SLN)in breast cancer.Methods Clinical data of 22 female patients with breast cancer confirmed by histopathological examination in Hainan Cancer Hospital from July 2019 to July 2020 were retrospectively analyzed.The patients aged between 37 and 73 years(the median age was 50.5 years).They underwent ^(99)Tc^(m)-Rituximab SPECT/CT imaging before surgery.The images were analyzed,and the number of SLN was counted.Operation was performed 1-2 h after the imaging,and a portableγdetector was used to detect SLN during the operation.The diagnostic efficacy of ^(99)Tc^(m)-Rituximab was evaluated using the number of SLN detected during the operation as the"gold standard".Results A total of 67 SLNs were detected by SPECT/CT imaging,most of which were 1-3(68%,15/22).A total of 81 SLNs were detected byγdetectors during the operation,and the majority of them were 2-4(73%,16/22).The sensitivity of ^(99)Tc^(m)-Rituximab imaging was 100%(22/22)when taking patients as unit,and the total coincidence rate was 100%(22/22).The sensitivity was 83%(67/81),the positive predictive value was 100%(67/67),and the total coincidence rate was 83%(67/81)when taking lymph node as unit.Conclusion ^(99)Tc^(m)-Rituximab SPECT/CT has high sensitivity and coincidence rate in the diagnosis of SLNs in breast cancer,and it has good clinical application.

关 键 词：乳腺肿瘤 前哨淋巴结 利妥昔单抗 体层摄影术 发射计算机 单光子 体层摄影术 X线计算机 

分 类 号：R737.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]