167例乳腺癌前哨淋巴结^99mTc-DX联合显像的临床分析

目的研究^99mTc-DX显影联合蓝染法及γ探测法在乳腺癌前哨淋巴结活检技术或淋巴结清扫手术中的应用价值。方法 167例乳腺癌患者于术前14～16h注射^99mTc-DX37～74MBq（1～2mCi）进行乳腺癌前哨淋巴结显影和定位,术中根据^99mTc-DX定位标记,利用蓝染法及γ探测法寻找活检或清扫乳腺癌前哨淋巴结,以病理为基础,统计活检或清扫乳腺癌前哨淋巴结的定位成功率。结果 ^99mTc-DX显影乳腺癌前哨淋巴结定位成功率为87.4%,^99mTc-DX显影联合蓝染法及γ探测法检测乳腺癌前哨淋巴结的成功率为91.6%,假阴性率为4.6%。结论 ^99mTc-DX显影体表定位可以准确显示乳腺癌前哨淋巴结的部位、数目及淋巴引流情况,可用于指导术中用γ探测定位乳腺癌前哨淋巴结活检或清扫。

To evaluate the clinical value of ^99mTc-DX integrated scintigraphy on 167 patients with breast cancer sentinel lymph node

Objective To evaluate the clinical value of ^99mTc-DX combined with methylene blue staining and γ-detecting probe on biopsy or cleaning surgery of sentinel lymph nodes in patients with breast cancer.Methods167 patients with breast cancer were injected ^99mTc-DX 37-74 MBq （1～2mCi） 14～16 hours before surgery to localize the sentinel lymph nodes. According to the scintigraphy of ^99mTc-DX, the sentinel lymph nodes were detected by methylence blue staining and γ-detecting probe during biopsy or cleaning surgery. The ratio of correctly localized lymph node for biopsy or cleaning surgery was analyzed according to the result of histopathologic examination.Results The ration of correctly localized sentinel lymph node by ^99mTc-DX was 87.4%, while by ^99mTc-DX combined with methylene blue staining and γ-detecting probe was 91.6%. The ration of false negative in the combined group was 4.6%.Conclusion ^99mTc-DX scintigraphy can show exactly the location, quantity and drainage situation of sentinel lymph nodes in patient with breast cancer. It can help to guide γ-detecting probe during biopsy or cleaning surgery on sentinel lymph nodes of the patient with breast cancer.