Department of Thoracic Surgery, Senology Unit, IRCCS Istituto Clinico Humanitas, Rozzano (Milano), Italy.
Med Sci Monit. 2012 Sep;18(9):CR543-9. doi: 10.12659/msm.883349.
The aim of this pilot trial was to study the feasibility of sentinel node percutaneous preoperative gamma probe-guided biopsy as a valid preoperative method of assessment of nodal status compared to surgical sentinel lymph node biopsy.
MATERIAL/METHODS: This prospective study enrolled 10 consecutive patients without evidence of axillary lymph node metastases at preoperative imaging. All patients underwent sentinel node occult lesion localization (SNOLL) using radiotracer intradermic injection that detected a "hot spot" corresponding to the sentinel node in all cases. Gamma probe over the skin detection with subsequent ultrasonographically guided needle biopsy of the sentinel node were performed. The percutaneous needle core histopathological diagnosis was compared to the results of the surgical biopsy.
Preoperative sentinel node identification was successful in all patients.
The combination of preoperative gamma probe sentinel node detection and ultrasound-guided biopsy could represent a valid alternative to intraoperative sentinel node biopsy in clinically and ultrasonographically negative axillary nodes, resulting in shorter duration of surgery and lower intraoperative risks.
本试验旨在研究前哨淋巴结经皮术前伽马探针引导活检作为一种评估淋巴结状态的术前方法的可行性，与外科前哨淋巴结活检相比。
材料/方法：本前瞻性研究纳入了 10 例术前影像学检查无腋窝淋巴结转移证据的连续患者。所有患者均采用放射性示踪剂皮内注射进行前哨淋巴结隐匿性病变定位（SNOLL），在所有病例中均检测到与前哨淋巴结相对应的“热点”。对皮肤进行伽马探针检测，随后对前哨淋巴结进行超声引导下的针吸活检。经皮针芯组织病理学诊断与手术活检结果进行比较。
所有患者均成功识别术前前哨淋巴结。
术前伽马探针前哨淋巴结检测与超声引导下活检相结合，可作为临床和超声阴性腋窝淋巴结中术中前哨淋巴结活检的有效替代方法，可缩短手术时间，降低术中风险。
