^(99m)Tc-SC淋巴显像在乳腺癌前哨淋巴结定位中的临床价值

Clinical application of ～(99m)Tc-SC lymphoscintigraphy in sentinel lymph node location in breast cancer

目的:回顾性评价99mTc-硫胶体(99mTc-SC)淋巴显像对乳腺癌前哨淋巴结(Sentinel lymph node,SLN)的定位准确性,为乳腺癌SLN活检技术提供准确的定位依据。方法:对50例乳腺癌患者行99mTc-SC前哨淋巴结显像,并进行体表定位;术中行γ探测仪探测定位SLN,并与显像体表定位结果作比较。患者均行腋窝淋巴结清扫,统计其检出率、准确率、假阴性率、假阳性率。结果:50例病人共有45例前哨淋巴结清晰显影,检出率为90.00%(45/50)。共显示SLN72个,平均1.60枚;淋巴显像检出的SLN与γ探针检测符合率为91.11(41/45枚);用淋巴显像检出的前哨淋巴结预测腋窝淋巴结转移的准确率为93.33%,特异度为100%,假阴性率为6.67%,假阳性率为0%。结论:99mTc-SC前哨淋巴结显像体表定位能较准确预测腋窝淋巴结转移情况,可用于指导乳腺癌SLNγ探测定位及活检手术。

Objective： Retrospectively evaluate the clinical value of 99mTc-Sc lymphoscintigraphy in sentinel lymph node （ SLN ） location in breast cancer, and to offer accurate orientation for sentinel lymph node biopsy （ SLNB ）. Methods ： Fifty breast cancer patients underwent99mTc-SC lymphoscintigraphy, the outcomes were compared with γ detection probe. Results：SLN was found in 45 of 50 cases （90.00%） ,the number of SLN was 1.60 in every case averagely. 41 patients were found in concordance with γ detection probe,4 cases were not detected by γ probe. The accuracy, specificity, false negative rate and false positive rate of SLN to predict axillary lymph node status were 93.33%, 100%,6.67% ,0%. Conclusion：99mTc-SC lymphoscintigraphy can exactly predict axillary lymph node status and guide γ detection probe and SLNB.