Mistrangelo M, Bellò M, Mobiglia A, Beltramo G, Cassoni P, Milanesi E, Cornaglia S, Pelosi E, Giunta F, Sandrucci S, Mussa A
Surgical and Oncological Department, University of Turin, Molinette Hospital, Turin, Italy.
Q J Nucl Med Mol Imaging. 2009 Feb;53(1):3-8. Epub 2008 Mar 12.
Anal cancer is a rare neoplasm. According to a European Organization for Research and Treatment of Cancer multivariate analysis, synchronous inguinal lymph node metastasis occurs in 10-25% of patients and constitutes an independent prognostic factor for local failure and overall mortality.
Inguinal lymph node status was assessed using the sentinel node technique in 35 patients with anal cancer.
Histology revealed 23 squamous carcinomas, 10 basaloid carcinomas, 1 squamous carcinoma with basaloid areas and 1 spinocellular epithelioma associated with areas of Bowen's disease. Disease stage was T1 in 5 patients, T2 in 18, T3 in 11 and T4 in 1 patient. Lympho-scintigraphy using a GE Millennium gamma camera was performed after peritumoral injection of 37 MBq of 99mTc colloid. Surgical sentinel node biopsy with a portable Scintiprobe MR 100 (Politech, Carsoli, Italy) had a detection rate of 97.1%. Inguinal metastases were detected in 7 (20%) patients, in 2 of which metastasis was bilateral.
Given the correlation between prognosis and node involvement, sentinel node biopsy can be considered a simple method for adequate pretreatment staging of anal carcinoma. Use of the technique could avert the need for prophylactic inguinal radiotherapy in N0-N1 patients, thus reducing the morbidity associated with inguinal radiotherapy. Consistent follow-up is required to evaluate long-term results:
肛管癌是一种罕见的肿瘤。根据欧洲癌症研究与治疗组织的多变量分析，10%-25%的患者会出现同步腹股沟淋巴结转移，这是局部复发和总死亡率的独立预后因素。
采用前哨淋巴结技术对35例肛管癌患者的腹股沟淋巴结状态进行评估。
组织学检查显示，有23例鳞状细胞癌、10例基底样癌、1例伴有基底样区域的鳞状细胞癌和1例与鲍恩病区域相关的棘细胞上皮瘤。疾病分期为T1期5例、T2期18例、T3期11例、T4期1例。在肿瘤周围注射37 MBq的99mTc胶体后，使用GE Millennium伽马相机进行淋巴闪烁显像。使用便携式Scintiprobe MR 100（意大利卡尔索利波利泰克公司）进行手术前哨淋巴结活检，检出率为97.1%。7例（20%）患者检测到腹股沟转移，其中2例为双侧转移。
鉴于预后与淋巴结受累之间的相关性，前哨淋巴结活检可被视为肛管癌充分术前分期的一种简单方法。使用该技术可避免对N0-N1期患者进行预防性腹股沟放疗，从而降低与腹股沟放疗相关的发病率。需要持续随访以评估长期结果：
