【摘要】 目的:探讨不同部位注射^99mTc-硫胶体(^99mTc-SC)对前哨淋巴结（sentinellymphnode,SLN）检出率的影响。方法:将治疗前的乳腺癌患者随机分为两组,分别进行乳晕周围（晕周）、肿瘤周围（瘤周）皮下注射^99mTc-SC2h后SPECT平面显像。个别患者加做SPECT/CT断层显像以鉴别是淋巴结还是前后方向的淋巴管,以平面显像结果为分析依据。检验分析两种注射部位,以及年龄、绝经状态及肿块大小等个体因素对腋窝前哨淋巴结（axillary sentinel lymph node,A-SLN）、内乳前哨淋巴结（internal mammary sentinel lymph node,IM-SLN）及总前哨淋巴结（total sentinel lymph node,T-SLN）检出率的影响。结果:共入组558例患者,A-SLN、IM-SLN及T-SLN检出率为78.7%、12.0%及80.6%。558例患者中173例患者进行瘤周注射,385例患者进行晕周注射,其A-SLN、IM-SLN、T-SLN检出率分别为65.3%、19.7%、69.4%和84.7%、8.6%、85.7%。年龄较小、尚未绝经的患者T-SLN和A-SLN显影率显著高于年龄高、已绝经患者的显影率,差异有统计学意义（P均<0.001）;IM-SLN显影率不受年龄和绝经状态的影响。晕周注射后T-SLN、A-SLN显影率显著高于瘤周注射后的显影率,差异有统计学意义（P均<0.001）;但瘤周注射后IM-SLN的显影率明显高于晕周注射后的显影率,差异有统计学意义（P<0.001）。结论:年龄较小的患者,晕周注射能获得更高的A-SLN阳性检测率,但IM-SLN检出率低。更多还原

【Abstract】 Objective: To explore the effect of different injection locations of ^99mTc-sulfur colloid(^99mTc-SC) for sentinel lymph node detection in breast cancer. Methods: Breast cancer patients before treatment were divided into two groups randomly according to subcutaneous injection locations（areola or tumor around）. All patients underwent SPECT planar scan 2 hours after ^99mTc-SC injection. SPECT/CT scan was performed to distinguish lymph node or vessel in some patients. χ2 test was used to analyze the influence of two injection locations and clinic individual characteristics, such as age, menopausal stage and tumor size, on the detection rates of axillary sentinel lymph node（A-SLN）, internal mammary sentinel lymph node（IM-SLN） and total sentinel lymph node（T-SLN）. Results: The detection rates of A-SLN, IM-SLN and T-SLN were 78.7%, 12.0% and 80.6%, respectively in 558 enrollment patients. Total 173 patients injected around the tumor. Among these patients, the detection rates of A-SLN, IM-SLN and T-SLN were 65.3%, 19.7% and 69.4%, respectively. Areola around injection was performed in each of 385 patients, and the detectionrates of A-SLN, IM-SLN and T-SLN were 84.7%, 8.6% and 85.7%, respectively. The detection rates of T-SLN（P<0.001） and A-SLN（P<0.001） in young（P<0.001） and nonmenopausal（P<0.001） patients were higher significantly than old and menopausal patients. However, age（P=0.436） and menopausal stage（P=0.354） didn’t effect the detection rate of IM-SLN. The detection rates of T-SLN（P<0.001）, A-SLN（P<0.001） were higher significantly in patients with areola around injection than patients with tumor around injection. However, the detection rate of IM-SLN（P<0.001） in patient with areola around injection was lower compared with patients with tumor around injection. Conclusion: Young patients with areola around injection had high detection rate of A-SLN, not IM-SLN.更多还原