放射导向手术在肺腺癌胸内转移淋巴结检测中的意义

Significance of Radionuclide Guided Surgery (RIGS) in Detecting Intrathoracic Metastatic Lymph Node in Lung Adenocarcinoma

[目的]探讨肺腺癌病人检测99mTc-甲氧基异丁基异腈(MIBI)对胸内淋巴结廓清术的临床意义。[方法]选取手术治疗前行99mTc-MIBI标记的肺腺癌病人30例,用γ探测仪(GDP)探测病人肺内和纵隔淋巴结及切除的标本,术后对放射导向手术判定为阳性而术后常规病理为阴性的淋巴结,即假阳性进行连续切片,HE染色,显微镜下观察。[结果]应用GDP探测淋巴结,其敏感度为100%,特异度为98.8%,准确率为98.6%。[结论]放射导向手术在术中能直接、客观提示肿瘤及其浸润、转移范围,指导手术廓清。

[Purpose] To explore the clinical significance of detecting ^99mTc-methoxy-isobutyl-isonitrile（MIBI） for intrathoracic metastatic lymph nodes dissection in lung adenocarcinoma. [Methods ] ^99mTc-MIBI labeled lesion in 30 cases with lung adenocarcinoma preoperation were included. Intrathoracic, mediastinal lymph nodes and specimens in these cases were detected by gamma-detecting probe （GDP）. After operation, RIGS positive node but pathologically negative was determined as false positive. Those were microscopically observed with continuously slice and HE-stain. [Results] The sensitivity of GDP detection was 100%; specificity, 98.8%; and accuracy, 98.6%. [Conclusion] RIGS could reveal tumor extension, invasion and metastasis. It is helpful for lymph nodes dissection.