摘要
目的在肺癌手术中应用99mTc探测前哨淋巴结,提高术中清除纵隔淋巴结的准确性。方法研究对象为24例非小细胞肺癌患者。术中将99mTc硫胶体溶液在肺肿瘤的6个部位分别注射,用γ射线探测器探测肺门、纵隔各部位淋巴结的放射活性计数值。常规行肺切除术,将所探测的淋巴结分别切除并行常规病理检查。结果24例共清除淋巴结158枚,其中前哨淋巴结即阳性转移淋巴结42枚,阳性转移率26.6%。前哨淋巴结的99mTc放射活性计数值为4930.79±6321.97,阴性淋巴结的计数值为8545.47±3505.32(P<0.001)。结论99mTc术中标记前哨淋巴结有助于提高转移淋巴结的检出率,能够更便捷、直观、准确地提示纵隔转移淋巴结。
Objective To improve the veracity of eliminating the mediastinal lymph nodes in non - small cell lung cancer inpatients by using the radioactive technetium-99m sulfur colloid to explore the sentinel lymph nodes during surgery. Methods Twenty four patients suffering from the non-small-cell lung cancer（NSCLC） were included. A dosage of 9-10（9.69 ± 0.46）MCi radioactive technetium-99m （^99m Tc）sulfur colloid was injected into the peri-tumor regions. Forty minutes after injection, the radioactivity of the hilar and the mediastinal lymph nodes was counted in vivo with a handhold gamma counter before dissection. All dissected lymph nodes were examined postoperatively by routine HE staining and immunohistochemical staining. Results Forty-two positive sentinel lymph nodes were identified in158 lymph nodes removed （the positive metastatic rate was 26. 6% ）. The radioactivity count value in the positive sentinel lymph node was 14930. 79 ± 6321.97 compared with 8545.47 ± 3505.32 in negative node （ P 〈 0. 001 ）. Conclusion The identification of the positive sentinel nodes using ^99m Tc sulfur colloid injection during surgery of non - small cell lung cancer is a reliable method. It could be an in vivo useful approach to guide mediastinal lymph node sampling or dissection.
出处
《中国肿瘤临床与康复》
2007年第3期193-195,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
