纳米碳联合^(99m)Tc-硫胶体SPECT/CT显像在乳腺癌前哨淋巴结识别定位中的应用价值  

Application value of carbon nanoparticles combined with ^(99m)Tc-sulfur colloid SPECT/CT imaging in sentinel lymph node identification and localization of breast cancer

作　　者：王雪霁 郭莹[1,3] 王静[1,2] 张荣[1,2] 李海霞 梁瑞[1,2] 张雪艳 付廷岩[1,2] 郝宏毅[1,2] WANG Xueji;GUO Ying;WANG Jing;ZHANG Rong;LI Haixia;LIANG Rui;ZHANG Xueyan;FU Tingyan;HAO Hongyi(Department of Nuclear Medicine,People's Hospital of Ningxia Autonomous Region,Yinchuan 750002,China;Department of Nuclear Medicine,the First Affiliated Hopsital of Northwest Minzu University,Yinchuan 750002,China;Department of Oncology,the First Affiliated Hospital of Northwest Minzu University,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院核医学科,宁夏银川750002 [2]西北民族大学第一附属医院核医学科,宁夏银川750002 [3]西北民族大学第一附属医院肿瘤科,宁夏银川750002

出　　处：《宁夏医学杂志》2022年第2期97-101,共5页Ningxia Medical Journal

基　　金：宁夏回族自治区人民医院培育振兴科研项目(201929)。

摘　　要：目的探讨纳米碳联合^(99m)Tc-硫胶体SPECT/CT显像在乳腺癌前哨淋巴结(SLN)识别定位中的应用价值。方法收集诊断为早期乳腺癌患者94例。根据示踪方法随机分为纳米碳联合^(99m)Tc-硫胶体SPECT/CT显像双示踪组(44例)和纳米碳单示踪组(50例),比较2组患者SLN检出量、检出率、准确率、灵敏度及假阴性的差异率。结果双示踪组SLN平均检出数为(3.4±1.33)枚,SLN检出率、准确率、灵敏度、假阴性率分别为90.9%、55.0%、85.7%、7.1%、2.8%;单示踪组SLN平均检出数为(3.08±1.3)枚,SLN检出率、准确率、灵敏度、假阴性率分别为88%、65.9%、64.3%、8.6%、9.5%,差异无统计学意义(P>0.05)。对2组患者肿瘤病理类型、年龄、肿瘤位置、分期、分子分型、月经情况及BMI分层比较,SLN检出率差异无统计学意义(P>0.05);再对肿瘤直径进行分层,肿瘤直径>2 cm的患者,双示踪组SLN检出率显著高于单示踪组,差异有统计学意义(P<0.05)。结论两种示踪法在乳腺癌SLN识别定位效果相似,但对于肿瘤直径>2 cm的患者,双示踪法能提高SLN检出率,降低漏诊,减少手术操作时间。Objective To evaluate the application value of carbon nanoparticles combined with ^(99m)Tc-SC SPECT/CT imaging in identifying and locating the sentinel lymph node in breast cancer.Methods 94 patients diagnosed with early breast cancer were collected.According to the tracing method,they were randomly divided into carbon nanoparticles combined with ^(99m)Tc SC SPECT/CT imaging double tracing group(44 cases)and carbon nanoparticles single tracing group(50 cases).The detection amount,detection rate,accuracy,sensitivity and false negative rate were compared between the two groups.Results The average number of SLN detected in the double tracer group was 3.4±1.33,the SLN detection rate,accuracy rate,sensitivity and false negative rate were 90.9%,55.0%,85.7%,7.1% and 2.8%;The average number of SLN detected in the single tracer group was(3.08±1.3)%,the SLN detection rate,accuracy rate,sensitivity and false negative rate were 65.9%,64.3%,8.6% and 9.5%.There was no significant difference(P>0.05).After comparing the tumor pathological type,age,tumor location,stage,molecular typing,menstrual status and BMI,there was no statistically significant difference in SLN detection rate between the two groups(P>0.05).In the tumor diameter>2 cm,the detection rate of SLN in double tracer group was significantly higher than that in single tracer group(P<0.05).Conclusion The two tracer methods have similar effects in SLN identification and localization in breast cancer.However,for patients with large tumor diameter(>2 cm),the double tracer method can improve the detection rate of SLN,reduce the missed diagnosis and the operation time.

关 键 词：乳腺癌 前哨淋巴结 ^(99m)Tc-硫胶体SPECT/CT 纳米碳 

分 类 号：R737.9[医药卫生—肿瘤]