摘要
目的分析99mTc-美罗华作为示踪剂对102例原发性乳腺癌(其中1例为双乳癌)患者行前哨淋巴结(SLN)显像及活检的诊断效能。方法超声引导下于乳腺肿块周围及肿块表面皮下注射99mTc-美罗华后行SLN显像,并将采集到的图像与患者数码局部大体像进行图像融合。术中凭此融合图像行腋窝区前哨淋巴结活检术(SLNB)。切除SLN后,行常规乳腺癌手术及腋下淋巴结清扫术,并送病理行常规HE染色及免疫组化检查。结果103例次SLN显像成功率100%,共显示SLN177枚,分布于腋窝区、内乳区及乳腺组织内,平均1.72枚(177/103)。腋窝区SLNB成功率99.03%(102/103),共探测到SLN266枚,平均2.58枚(266/103)。病理发现腋窝SLN有转移者76例次,转移SLN110枚。与腋清扫淋巴结病理结果比较,SLNB的灵敏度为96.20%(76/79),特异性为100%(24/24),假阴性率为3.80%(3/79),准确率为97.09%(100/103)。结论应用新型SLN示踪剂99mTc-美罗华行乳腺癌SLN显像及活检成功率、灵敏度及准确率高,假阴性率较低,具有临床应用价值。
Objective To study the feasibility and reliability of the sentinel lymph node （SLN） imaging and biopsy with a new imaging agent ^99mTc-Rituximab in 102 breast cancer patients （one suffered bilateral breast cancers）. Methods The sentinel lymph node imaging was taken after peritumoral and subdermal injection of ^99mTc-Rituximah guided with ultrasound, and was fused with each digital photo. After the sentinel lymph node biopsy （SLNB）, routine surgery of breast and axillary lymph node dissection （ALND） was performed. Fresh SLNs and all axillary nodes were examined by pathology. Results There were total 103 times SLN imaging and SLNB in 102 patients, and the success rate of the SLN imaging was 100%. Total 177 SLNs （the average was 1.72） were showed in the images, which distributed in the axilla, the internal mammary and the breast region. The success rate of SLNB was 99.03%, and total 266 SLNs （the average was 2.58） were identified. Pathological examination showed that there were 76 times of metastatic SLN and the total number of metastatic SLN were 110. The sensitivity, specificity and accuracy of SLNB were 96.20%, 100% and 97.09%, respectively; and the false negative rate of SLNB was 3.80%. Conclusion Using ^99mTc-Rituximab as the imaging agent, the sentinel lymph node imaging and biopsy can obtain high success rate, high sensitivity and accuracy, and low false negative rate, so this novel sentinel lymphoscintigraphy agent will have a good future in clinical practice.
出处
《中国医学影像技术》
CSCD
北大核心
2009年第4期681-684,共4页
Chinese Journal of Medical Imaging Technology
关键词
美罗华
乳腺肿瘤
前哨淋巴结活检
Rituximab
Breast neoplasms
Sentinel lymph node biopsy
