Wong J H, Terada K, Ko P, Coel M N
Department of Surgery, University of Hawaii School of Medicine, Honolulu 96813, USA.
Ann Surg Oncol. 1998 Jan-Feb;5(1):77-80. doi: 10.1007/BF02303767.
Radiotracers have become a routine technical component of the new procedure of intraoperative lymphatic mapping and selective lymphadenectomy. Because different colloids have differing physicochemical properties, their distribution and uptake may be different. For this reason, the optimal colloid to identify and localize the sentinel node remains controversial.
Nineteen consecutive patients with cutaneous malignancies underwent diagnostic lymphoscintigraphy with 99mTc-labeled human serum albumin (99mTc-HSA) and preoperative lymphoscintigraphy with 99mTc-labeled sulfur colloid (99mTc-SC). The results of intraoperative lymphatic mapping and selective lymphadenectomy were reviewed.
Intraoperative lymphatic mapping and selective node dissection were successful in 21 of 22 lymphatic basins (18 of 19 patients). There was excellent correlation between the "hot" marker placed on the skin surface when 99mTc-HSA was used compared with the use of 99mTc-SC. In 20 of 21 lymphatic basins the sentinel node both was "hot" and was stained with isosulfan blue.
No discernible difference between the ability to localize in the sentinel node with these two radiocolloids was identified. For logistical reasons, 99mTC-SC appears to be the colloid of choice in intraoperative lymphatic mapping.
放射性示踪剂已成为术中淋巴绘图和选择性淋巴结清扫新程序的常规技术组成部分。由于不同的胶体具有不同的物理化学性质，它们的分布和摄取情况可能不同。因此，用于识别和定位前哨淋巴结的最佳胶体仍存在争议。
19例连续的皮肤恶性肿瘤患者接受了用99mTc标记的人血清白蛋白（99mTc-HSA）进行的诊断性淋巴闪烁显像，以及用99mTc标记的硫化胶体（99mTc-SC）进行的术前淋巴闪烁显像。回顾了术中淋巴绘图和选择性淋巴结清扫的结果。
22个淋巴区域中的21个（19例患者中的18例）术中淋巴绘图和选择性淋巴结清扫成功。与使用99mTc-SC相比，使用99mTc-HSA时放置在皮肤表面的“热点”标记之间具有极好的相关性。在21个淋巴区域中的20个中，前哨淋巴结既是“热点”，又被异硫蓝染色。
未发现这两种放射性胶体在前哨淋巴结定位能力上有明显差异。出于后勤方面的原因，99mTc-SC似乎是术中淋巴绘图中首选的胶体。
