Zámbó Katalin, Schmidt Erzsébet, Hartmann Tamás, Kornya László, Dehghani Babak, Tinneberg Hans Rudolf, Bódis József
Department of Nuclear Medicine, University of Pécs, Faculty of Medicine, Hungary.
Eur J Nucl Med Mol Imaging. 2002 Sep;29(9):1198-200. doi: 10.1007/s00259-002-0890-6. Epub 2002 Jul 23.
Lymph node status is the most important prognostic factor in vulvar malignancy. The aim of this pilot study was to explore the clinical significance of radionuclide lymphoscintigraphy in the management of vulvar neoplasms. Eight patients with squamous cell carcinoma and two patients with malignant melanoma of the vulva were studied with 100 MBq technetium-99m nanocolloid (Sentiscint, OSSKI, Budapest) 1 day before surgery. The location of the sentinel lymph node was checked by a single-head gamma camera-computer system (MB 9200, Mediso, Budapest). Vulvectomy with bilateral inguinofemoral lymphadenectomy was performed in each case. At lymphadenectomy, the sentinel lymph node was separately removed and histologically studied. Three of the ten patients had positive sentinel lymph nodes (micrometastasis). Five months later one of them had local recurrence of the vulvar cancer, and another had inguinal recurrence of the tumour 6 months postoperatively; the third patient was operated on only recently. Our preliminary results are impressive and suggest that lymphoscintigraphy is an easy and reliable method for detection of the sentinel lymph node in vulvar malignancy.
淋巴结状态是外阴恶性肿瘤最重要的预后因素。本初步研究的目的是探讨放射性核素淋巴闪烁造影术在外阴肿瘤治疗中的临床意义。对8例鳞状细胞癌患者和2例外阴恶性黑色素瘤患者在手术前1天用100MBq的99m锝纳米胶体（Sentiscint，OSSKI，布达佩斯）进行研究。通过单头γ相机 - 计算机系统（MB 9200，Mediso，布达佩斯）检查前哨淋巴结的位置。每例均行外阴切除加双侧腹股沟股淋巴结清扫术。在淋巴结清扫术中，单独切除前哨淋巴结并进行组织学研究。10例患者中有3例前哨淋巴结阳性（微转移）。5个月后，其中1例出现外阴癌局部复发，另1例在术后6个月出现腹股沟肿瘤复发；第3例患者最近才接受手术。我们的初步结果令人印象深刻，表明淋巴闪烁造影术是检测外阴恶性肿瘤前哨淋巴结的一种简便可靠的方法。
