Maublant J, de Latour M, Mestas D, Clemenson A, Charrier S, Feillel V, Le Bouedec G, Kaufmann P, Dauplat J, Veyre A
Department of Nuclear Medicine, Centre Jean Perrin, Faculty of Medicine, Clermont-Ferrand, France.
J Nucl Med. 1996 Jun;37(6):922-5.
The aim of this study was to measure the accumulation of 99mTc-sestamibi in breast tumors and their axillary lymph nodes in patients undergoing scintimammography.
Eighteen patients who were scheduled for breast surgery underwent scintimammography with 740 MBq of 99mTc-sestamibi on the day before the operation. The next morning, reinjection with 370 MBq was performed. Immediately after the surgical procedure, the 99mTc activity of the tumor samples and, when available, the related lymph nodes was measured in a gamma counter. The samples were weighed and prepared for histological analysis. The activity of each sample was normalized to the mean activity of normal tissue samples obtained from the same patient.
Among the 198 samples analyzed, the relative uptake of sestamibi was increased in 111 containing normal lymph nodes (1.80+/-0.79 vs 1.00+/-0.22, p<0.05), as well as in the seven containing invaded lymph nodes (2.01+/-0.83, p<0.01) and more dramatically, in the 22 with a carcinoma (5.64+/-3.06, p<0.001). In two patients with a benign lesion, both scintigraphy and counting demonstrated increased activity in the tumor. Four patients had negative scan results despite the presence of malignant tumor and a more than fourfold increase of sestamibi concentration in two of them.
Technetium-99m-sestamibi concentrates strongly in breast carcinoma, sometimes even when the scan results appear normal, and mildly in lymph nodes, especially when invaded; it also concentrates in some benign tumors, possibly in relation to the presence of epithelial hyperplasia.
本研究的目的是测量在进行乳腺闪烁显像的患者中，99mTc-司他米比在乳腺肿瘤及其腋窝淋巴结中的蓄积情况。
18例计划接受乳腺手术的患者在手术前一天接受了740MBq的99mTc-司他米比乳腺闪烁显像。次日早晨，再次注射370MBq。手术操作完成后，立即在γ计数器中测量肿瘤样本以及（若有）相关淋巴结的99mTc活性。对样本进行称重并准备进行组织学分析。将每个样本的活性标准化为从同一患者获得的正常组织样本的平均活性。
在分析的198个样本中，司他米比的相对摄取在111个含有正常淋巴结的样本中增加（1.80±0.79对1.00±0.22，p<0.05），在7个含有受侵淋巴结的样本中增加（2.01±0.83，p<0.01），更显著的是在22个患有癌的样本中增加（5.64±3.06，p<0.001）。在两名患有良性病变的患者中，闪烁显像和计数均显示肿瘤活性增加。4名患者尽管存在恶性肿瘤但扫描结果为阴性，其中两名患者的司他米比浓度增加了四倍以上。
99mTc-司他米比在乳腺癌中浓聚强烈，有时即使扫描结果看似正常也是如此，在淋巴结中轻度浓聚，尤其是在受侵时；它也在一些良性肿瘤中浓聚，可能与上皮增生的存在有关。
