^(99m)锝-右旋糖酐颈淋巴显像对喉癌和下咽癌颈淋巴结转移的诊断价值

The value of ^(99m)Tc-DX_(105)cervical lymphatic imaging in detecting cervical lymph node metastasis of laryngeal and hypopharyngeal carcinoma

目的:探讨乳突区皮下注射99m锝右旋糖酐(99mTcDX105)单光子发射计算机断层扫描(SPECT)颈淋巴显像对喉癌和下咽癌颈淋巴结转移的诊断价值。方法:对30例喉癌和下咽癌患者术前经双侧乳突区皮下注射99mTcDX105SPECT颈淋巴显像与颈廓清标本病理检查进行对比研究。结果:30例患者53侧颈部SPECT,显像阳性24侧,其中3侧为假阳性;阴性29侧,其中1侧为假阴性。53侧SPECT颈淋巴显像的敏感性、特异性及准确率分别为95.5%(21/22)、90.3%(28/31)和92.5%(49/53)。8侧隐匿性转移淋巴结中SPECT显像检出7侧,检出率为87.5%(7/8)。结论:乳突区皮下注射99mTcDX105SPECT颈淋巴显像对指导喉癌和下咽癌的临床分期及颈淋巴结清扫,具有一定的临床意义。

Objective：To study the value of single photon emission-computed tomography（SPECT） lymphatic imaging by percutaneous injection of ^99mTc-DX105 in detecting cervical lymph node metastasis of laryngeal and hypopharyngeal carcinoma. Method：One- three days before the operation, 185MBq ^99mTc-DX105 was injected via bi- lateral mastoids portion percutaneously in each of 30 patients with laryngeal and hypopharygeal carcinoma, and thus SPECT lymphatic imaging was conducted. Then, the diagnostic result was compared with those of pathological examination of neck dissection specimens. Result：In SPECT lymphatic imaging of 53 sides neck of 30 patients, 24 sides cervical lymph node were positive, and 3 sides were false positive;29 sides cervical lymph node were negative, and 1 side was false negative, Sensitivity, specificity and accuracy of SPECT lymphatic imaging were 95.5% （21/22） ,90.3% （28/31）and 92.5% （49/53）respectively. Among the 8 sides cervical lymph node metastasis which were false negative by clinical palpation,7 sides were positive by SPECT lymphatic imaging. Conclusion： It is suggested that SPECT lymphatic imaging by percutaneous injection of ^99mTc-DX105 in detecting cervical lymph node metastasis of laryngeal and hypopharyngeal carcinoma is pretty valuable for guiding clinical neck node dissection.