前哨淋巴結之核醫檢查

Sentinel Node Localization by Lymphoscintigraphy

葉大鑄(Samue D.J.Yeh) ； 張宏達(Hong-Da Chang) ； 黃文盛(Wen-Sheng Huang)

《核子醫學雜誌》 15卷1期 (2002/03) Pp. 43-48

https://doi.org/10.6332/ANMS.1501.007

摘要

手術中淋巴引流圖譜及前哨淋巴結剝除技術改變了患有塊狀腫瘤病人淋巴結擴散的處置方式。有報告指出核醫淋巴造影，包括影像及手術中探查技術，對乳癌及黑色素癌前哨淋巴結的確認扮演重要角色，至於其他癌症如食道癌、胃癌、大腸癌、甲狀腺癌、肺癌、皮膚癌、頭頸部癌、生殖及泌尿道癌症的應用也正積極評估與追蹤。精確確認前哨淋巴結將是影響病患治療受惠與否的重要因素，而此一技術的發展則有賴醫療團隊的共同努力，包括：核醫醫師能否提供足夠的訊息確認前哨淋巴結，外科醫師能否確切地將這些淋巴結找到並切除，病理工程師能否作快速且正確的檢體分析及診斷，以及基礎科學家能否提供必要的技術支援及相關訊息。目前資料顯示核醫前哨淋巴結檢查較傳統的淋巴探查手術或利用染料(vital blue)方法偵測的前哨淋巴結的效率為佳，不僅減小手術的範圍和降低病患的傷害，也可提供更有效的癌病分期與確定日後的治療計畫。

關鍵字

前哨淋巴結 ； 核醫淋巴造影 ； 同位素偵檢器

並列摘要

Intra-operative lymphatic mapping and sentinel node dissection have revolutionized the management of lymph node basin in patients with many malignancies. Striking advances have been made particularly in the management of malignant melanoma and newly diagnosed early stage of breast cancer.Lymphoscintigraphy provided by nuclear medicine physicians, intra-operative detection and removal of lymph nodes by surgeons and more critical analysis in addition to the routine frozen sections, hematoxyllin-eosin stains and immuno-histological stains for tumor cells by pathologists have important impact in the management of tumor patients. Many unanswered questions related to lymphatic spread and prevention may still need more basic research by scientists with diversified training and expertise.
The concept of sentinel node localization has been greatly expanded in recent years to many malignancies such as gastrointestinal cancer, thyroid cancer, head and neck cancer or urogenital cancers.

並列關鍵字

sentinel node ； lymphoscintigraphy ； gamma probe