【摘要】 目的探讨99mTc标记硫胶体(99mTc-SC)淋巴显像探测皮肤恶性黑色素瘤前哨淋巴结(SLN)的临床应用价值和影响因素。方法选取99例Ⅰ、Ⅱ期皮肤恶性黑色素瘤患者,术前4~6 h在肿瘤病灶周围皮下注射显像剂99mTc-SC,行早期局部及延迟全身显像,结合显像进行体表定位。随后行前哨淋巴结活检术(SLNB),对初诊患者加行原发病灶切除术,对SLN及原发病灶行详细病理检查。结果 99mTc-SC的SLN总检出率为90.9%(90/99),检出率与原发灶部位有关(P<0.001);区间淋巴结检出率为7.1%(7/99);SLN转移阳性率为28.9%(26/90),与肿瘤的病理组织学特点(Breslow厚度、Clark分级)呈正相关;假阴性率为3.7%(1/27),灵敏度为96.3%(26/27),特异度为98.4%(63/64)。结论 99mTc-SC显像可准确显示SLN部位及淋巴引流情况,减少药物标记时间,进一步提高区域淋巴结检出,为恶性黑色素瘤区域淋巴结的诊治决策提供重要的临床依据。更多还原

【Abstract】 Objective To evaluate the clinical value of lymphoscintigraphy using 99mTc-labeled sulphur colloid(99mTc-SC) in sentinel lymph node identification for cutaneous melanoma. Methods A total of 99 patients with stage Ⅰ-Ⅱ cutaneous melanoma were injected with 99mTc-SC before preoperative lymphoscintigraphy. The sentinel lymph nodes were identified by regional lymphoscintigraphy and gamma probe, followed by resection. Results The detection rate of sentinel lymph nodes was 90.9%(90/99) and well connected with the site of the primary lesions. The interval lymph nodes were found in 7.1%(7/99)patients. 28.9%(26/90) melanomas had positive sentinel lymph nodes and were positively correlated with the Breslow depth and Clark level. Conclusion 99mTc-SC lymphoscintigraphy could detect sentinel lymph nodes in the patients with stage Ⅰ-Ⅱ cutaneous melanoma and predict regional node status.更多还原