Yalçin Hulya, Gençoglu Esra Arzu, Yagmurdur Mahmut, Aras Murat, Ozen Aynur, Aktas Ayse
Department of Nuclear Medicine, Mustafa Kemal University, Antioch, Hatay, Turkey.
Nucl Med Commun. 2010 Oct;31(10):903-9. doi: 10.1097/MNM.0b013e32833dedbf.
BACKGROUND AND AIM: This study compared the effectiveness of Tc-99m human polyclonal immunoglobulin (HIG) and Tc-99m nanocolloid at detecting sentinel lymph nodes (SLNs) with lymphoscintigraphy and an intraoperative gamma-probe (IGP) in patients with early breast cancer. METHODS: The study group consisted of 50 women; 25 patients each were given Tc-99m HIG or Tc-99m nanocolloid for lymphoscintigraphy. Then, intraoperative SLN localization with IGP was performed. The results of IGP, lymphoscintigraphy, blue dye injected just before surgery, and pathology were compared. RESULTS: In the Tc-99m HIG group, one patient had tumours in both breasts. In two patients, we could not detect SLNs with lymphoscintigraphy, although they were detected with IGP and blue dye. We found SLNs for all tumours with IGP. With the intraoperative blue dye, SLNs were identified for 25 tumours; for one tumour, no SLN was detected with blue dye. In the histopathological examination, 13 tumours showed metastasis in the SLN and in 11 of these 13, there were also metastases in the axilla. One patient had a skip metastasis. In the Tc-99m nanocolloid group, SLNs were identified in 24 patients with lymphoscintigraphy. IGP found SLNs in 24 patients. The blue dye detected SLNs in all patients. On histopathological examination, 10 patients had metastasis in the SLN and there were also metastases in the axilla in all of these patients. CONCLUSION: Tc-99m HIG can be used in SLN detection with preoperative lymphoscintigraphy and IGP in early-stage breast cancer patients.
背景与目的:本研究比较了锝-99m人多克隆免疫球蛋白(HIG)和锝-99m纳米胶体在早期乳腺癌患者中通过淋巴闪烁显像和术中γ探测仪(IGP)检测前哨淋巴结(SLN)的有效性。 方法:研究组由50名女性组成;25名患者分别接受锝-99m HIG或锝-99m纳米胶体进行淋巴闪烁显像。然后,使用IGP进行术中SLN定位。比较了IGP、淋巴闪烁显像、术前注射的蓝色染料以及病理检查的结果。 结果:在锝-99m HIG组中,1名患者双侧乳房均有肿瘤。2名患者通过淋巴闪烁显像未能检测到SLN,但通过IGP和蓝色染料检测到了。我们通过IGP检测到了所有肿瘤的SLN。术中使用蓝色染料时,25个肿瘤检测到了SLN;1个肿瘤未通过蓝色染料检测到SLN。在组织病理学检查中,13个肿瘤在SLN中显示有转移,在这13个肿瘤中的11个中,腋窝也有转移。1名患者有跳跃转移。在锝-99m纳米胶体组中,24名患者通过淋巴闪烁显像检测到了SLN。IGP在24名患者中检测到了SLN。蓝色染料在所有患者中都检测到了SLN。组织病理学检查显示,10名患者的SLN有转移,所有这些患者的腋窝也有转移。 结论:锝-99m HIG可用于早期乳腺癌患者术前淋巴闪烁显像和IGP检测SLN。
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