Beavis Alison, Dawson Michael, Doble Philip, Scolyer Richard A, Bourne Roger, Li Ling-Xi L, Murali Rajmohan, Stretch Jonathan R, Lean Cynthia L, Uren Roger F, Thompson John F
Department of Chemistry, Materials and Forensic Science, University of Technology, Sydney, New South Wales, Australia.
Ann Surg Oncol. 2008 Mar;15(3):934-40. doi: 10.1245/s10434-007-9693-0. Epub 2008 Jan 3.
The sentinel lymph node (SLN) biopsy technique is a reliable means of determining the tumor-harboring status of regional lymph nodes in melanoma patients. When technetium 99 m-labeled antimony trisulfide colloid (99 mTc-Sb2S3) particles are used to perform preoperative lymphoscintigraphy for SLN identification, they are retained in the SLN but are absent or present in only tiny amounts in non-SLNs. The present study investigated the potential for a novel means of assessing the accuracy of surgical identification of SLNs. This involved the use of inductively coupled plasma-mass spectrometry (ICP-MS) to analyze antimony concentrations in fine-needle biopsy (FNB) samples from surgically procured lymph nodes.
A total of 47 FNB samples from surgically excised lymph nodes (32 SLNs and 15 non-SLNs) were collected. The SLNs were localized by preoperative lymphoscintigraphy that used 99 mTc-Sb2S3, blue dye, and gamma probe techniques. The concentrations of antimony were measured in the FNB samples by ICP-MS.
The mean and median antimony concentrations (in parts per billion) were .898 and .451 in the SLNs, and .015 and .068 in the non-SLNs, the differences being highly statistically significant (P < .00005).
Our results show that ICP-MS analysis of antimony concentrations in FNB specimens from lymph nodes can accurately confirm the identity of SLNs. Used in conjunction with techniques such as proton magnetic resonance spectroscopy for the nonsurgical evaluation of SLNs, ICP-MS analysis of antimony concentrations in FNB samples could potentially serve as a minimally invasive alternative to surgery and histopathologic evaluation to objectively classify a given node as sentinel or nonsentinel and determine its tumor-harboring status.
前哨淋巴结（SLN）活检技术是确定黑色素瘤患者区域淋巴结肿瘤状态的可靠方法。当使用锝99m标记的三硫化二锑胶体（99mTc-Sb2S3）颗粒进行术前淋巴闪烁显像以识别SLN时，它们会保留在前哨淋巴结中，而在非前哨淋巴结中不存在或仅微量存在。本研究调查了一种评估手术识别前哨淋巴结准确性的新方法的潜力。这涉及使用电感耦合等离子体质谱（ICP-MS）分析手术获取的淋巴结细针穿刺活检（FNB）样本中的锑浓度。
共收集了47个手术切除淋巴结的FNB样本（32个前哨淋巴结和15个非前哨淋巴结）。通过使用99mTc-Sb2S3、蓝色染料和γ探针技术的术前淋巴闪烁显像来定位前哨淋巴结。通过ICP-MS测量FNB样本中的锑浓度。
前哨淋巴结中锑的平均浓度和中位数浓度（以十亿分之一计）分别为0.898和0.451，非前哨淋巴结中为0.015和0.068，差异具有高度统计学意义（P < 0.00005）。
我们的结果表明，对淋巴结FNB标本中的锑浓度进行ICP-MS分析可以准确确认前哨淋巴结的身份。与质子磁共振波谱等用于前哨淋巴结非手术评估的技术结合使用时，对FNB样本中的锑浓度进行ICP-MS分析可能作为一种微创替代手术和组织病理学评估的方法，以客观地将给定淋巴结分类为前哨或非前哨，并确定其肿瘤状态。
