内乳前哨淋巴结^99Tc^m-硫胶体显像影响因素分析

目的探讨内乳前哨淋巴结^99Tc^m-硫胶体（SC）显像的影响因素，为提高显像效果提供依据。方法分析263例T1或T2期乳腺癌患者的内乳前哨淋巴结”^99Tc^m-显像资料，选取患者年龄、肿块所在乳腺（左或右）、肿块所在象限、病灶性质、瘤周注射钟点位置、注射显像剂体积、显像剂放射性活度及显像延时时限共8个影响因素，用SPSS 11.5软件进行单因素和多因素分析，P〈0．05为差异有统计学意义。结果左乳较右乳（Wald值为27．71，P〈0．05）、内半乳腺较外半乳腺（Wald值为6．46，P=0．011）易出现内乳淋巴引流；瘤周3点注射法优于4点注射法（Wald值为11．57，P=0．001）；每点0．5×10^-3L^99Tc^m-SC注射能取得较好的显像效果；在活度一体积组合中，活度不是关键性因素。年龄（Wald值为3．20，P=0．074）、病灶性质（Wald值为0．05，P=0．82）及显像延时时限（Wald值为0．69，P=0．41）对内乳前哨淋巴结显像无明显影响。结论在选取的8个因素中，肿块所在乳腺（左或右）、肿块所在象限、瘤周注射钟点位置、注射显像剂体积为影响内乳淋巴结显影的独立因素，年龄、病灶性质及延时时限与内乳前哨淋巴结显像无关。

Factors affecting 99Tcm-sulphur colloid internal mammary sentinel nodes lymphoscintigraphy

Objective The aim of this study was to investigate the possible influential factors in 99Tcm-sulphur colloid (SC) internal mammary sentinel node (IMSN) lymphoscintigraphy. Methods IMSN lymphoscintigraphy data from 263 breast cancer patients with T1 or T2 tumors were retrospectively reviewed. Parameters including patients'age, left or right breast, various quadrants, focus properties, o'clock site around tumor of injection, injection volume, injection radioactivity and delay time of imaging were selected as influential factors to be analyzed by single factor and multifactor analyses with SPSS 11.5, significant value was P<0.05. Results Left breast and inner half breast were easier to drain to internal mammary nodes (IMN) than that of right breast and outer haft breast (Wald=27.71, P<0.05 and Wald=6.46, P< 0.05). Peri-tumoral injection with three sites was better than with four sites (Wald=11.57, P=0.001). A better imaging quality was gained in 0.5×10-3 L per site. Radioactivity, age, location of injection, and delay time were insignificant to identify the IMSN. Conclusion Left breast and inner half breast, injection site, and injection volume are all independent factors affecting IMSN lymphoscintigraphy.