Fernández A, Cortés M, Benito E, Azpeitia D, Prieto L, Moreno A, Ricart Y, Mora J, Escobedo A, Martín Comín J
Servicio de Medicina Nuclear, Hospital de Bellvitge, C/Feixa Llarga s/n, L'Hospitalet de Llobregat 08907, Barcelona, Spain.
Nucl Med Commun. 2001 Apr;22(4):361-6. doi: 10.1097/00006231-200104000-00003.
The aim of this study was to analyse the accuracy of scintigraphic and gamma probe sentinel node (SN) localization in breast cancer patients who have been submitted to neoadjuvant chemotherapy (NC). Seventy-six patients with single breast cancer were included in the study, and were classified into two groups. Group 1 consisted of 40 women who had received NC, and Group 2 consisted of 36 women who did not receive NC. All patients received 111 MBq (3 mCi) of 99Tcm-nanocolloid in 3 ml, by peritumoural injection. Anterior and lateral thoracic scans were obtained 2 h post-injection. The following day (18-24 h post-injection) the patients underwent surgery and sentinel nodes were localized by using a gamma probe. Complete axillary lymph node dissection was performed in all patients. Histological analysis included haematoxylin-eosin in all cases and immunohistochemistry in 10 cases. In Group 1, SNs were localized in 36/40 patients, histological analysis was performed in 34 and there were four false negatives (22%). In Group 2, SNs were localized in 32/36 patients, histological analysis was performed in 29 and there were two false negatives (9%). Predictive negative values were 78% and 90% in Groups 1 and 2, respectively. In summary, sentinel node localization in breast cancer patients submitted to previous neoadjuvant chemotherapy is less accurate than in patients who do not receive this therapy. The procedure is not sufficiently accurate to localize the sentinel node, thus it cannot be recommended in these patients.
本研究的目的是分析接受新辅助化疗（NC）的乳腺癌患者中，闪烁显像和γ探针前哨淋巴结（SN）定位的准确性。76例单发乳腺癌患者纳入本研究，分为两组。第1组由40例接受过NC的女性组成，第2组由36例未接受NC的女性组成。所有患者均通过瘤周注射3ml含111MBq（3mCi）的99Tcm-纳米胶体。注射后2小时进行胸部前后位和侧位扫描。次日（注射后18 - 24小时）患者接受手术，使用γ探针定位前哨淋巴结。所有患者均行腋窝淋巴结清扫术。组织学分析包括所有病例的苏木精-伊红染色及10例病例的免疫组化染色。第1组中，40例患者中有36例定位到了前哨淋巴结，对34例进行了组织学分析，有4例假阴性（22%）。第2组中，36例患者中有32例定位到了前哨淋巴结，对29例进行了组织学分析，有2例假阴性（9%）。第1组和第2组的预测阴性值分别为78%和90%。总之，接受过新辅助化疗的乳腺癌患者前哨淋巴结定位的准确性低于未接受该治疗的患者。该方法在前哨淋巴结定位方面不够准确，因此不推荐用于这些患者。
