California Pacific Medical Center and Research Institute, San Francisco, CA, USA.
University of California School of Medicine San Francisco, San Francisco, CA, USA.
Clin Exp Metastasis. 2022 Feb;39(1):39-50. doi: 10.1007/s10585-021-10137-4. Epub 2021 Dec 28.
Technetium-99m-labeled Tilmanocept or Lymphoseek® (Cardinal Health, Dublin, Ohio) is a soluble, synthetic molecule with a small diameter (7 nm), which is comprised of technetium-99m chelated to a dextran backbone containing multiple units of mannose ligands with a high affinity for CD206, a receptor located on the surface of macrophages and dendritic cells that are found in high concentration in lymph nodes. It enables quick transit from the injection site and rapid lymph node accumulation. The binding of mannose ligand and CD206 results in the internalization of the ligand and receptor into the cell. Once the Technetium-99m-labeled Tilmanocept (Lymphoseek®) reaches the lymph node, it is readily internalized by the macrophages and dendritic cells within the draining lymph nodes. Technetium-99m-labeled Tilmanocept (Lymphoseek®) has been extensively studied as a radioisotope for detection of sentinel lymph nodes in melanoma, breast cancer and head and neck squamous cell carcinoma in clinical trials. Based on its safety and ability to detect sentinel lymph nodes satisfactorily, it has been approved by the FDA to use as a radioisotope for preoperative lymphoscintigraphy for identification of sentinel lymph nodes in these types of cancer. Further, the FDA has expanded approval of Technetium-99m-labeled for sentinel lymph node mapping of all solid tumors as well as in pediatric patients.
锝 99m 标记的替拉诺肽或淋巴示踪剂（Cardinal Health，俄亥俄州都柏林）是一种可溶性的合成分子，直径较小（7nm），由锝 99m 螯合到含有多个甘露糖配体单元的葡聚糖骨架上，这些配体对位于巨噬细胞和树突状细胞表面的 CD206 具有高亲和力，而巨噬细胞和树突状细胞在淋巴结中高度集中。它能使药物迅速从注射部位转运到淋巴结，并迅速在淋巴结中积累。甘露糖配体与 CD206 的结合导致配体和受体被内化到细胞内。一旦锝 99m 标记的替拉诺肽（淋巴示踪剂）到达淋巴结，它就会被引流淋巴结中的巨噬细胞和树突状细胞迅速内吞。锝 99m 标记的替拉诺肽（淋巴示踪剂）已在临床试验中作为放射性同位素广泛研究用于检测黑色素瘤、乳腺癌和头颈部鳞状细胞癌的前哨淋巴结。基于其安全性和检测前哨淋巴结的能力，它已获得 FDA 批准用于这些类型癌症的术前淋巴闪烁显像以识别前哨淋巴结。此外，FDA 已扩大了锝 99m 标记用于所有实体瘤和儿科患者的前哨淋巴结绘图的批准。
