Sentinel Lymph Nodes Detection via Lymphoscintigraphy in Patient with Breast Cancer: Comparison of One-Site and Two-Site Intradermal Injections

淋巴腺掃偵測乳癌患者的前哨淋巴節：比較核醫藥物注射一處與注射兩處的差異

莊志堅(Jr-Jian Juang) ； 魯祐祐(Y. Yu Lu) ； 王心怡(Y. Hsin Wang) ； 蔡世傳(Shih-Chuan Tsai) ； 林萬鈺(Wan-Yu Lin)

《核子醫學暨分子影像雜誌》 27卷3期 (2014/09) Pp. 171-176

https://doi.org/10.6332/ANMMI.2703.001

摘要

背景：相較於腋下淋巴結清除手術，使用淋巴腺掃描進行前哨淋巴結切片，可降低術後併發症的比例。本研究希望能了解，增加核醫藥物注射部位，是否可以提高前哨淋巴節偵測率與偵測數量。方法：回溯性收集189位台中榮總2008~2009年間乳癌患者的資料。所有患者皆接受術前淋巴腺掃描，使用鎝-99m phytate進行乳暈旁、皮內注射。A組（97人）注射一處；B組（92人）注射兩處。造影後，使用統計方法分析前哨淋巴節偵測率與偵測數量。結果：A、B組前哨淋巴節偵測率分別為96.9%與99.0%(P = 0.312)。A、B組前哨淋巴節平均偵測數量分別為1.5與1.9(P = 0.029)。結論：在乳癌患者身上，執行淋巴腺掃描，注射兩處核醫藥物的方式，有增加前哨淋巴節偵測率的傾向，而且可以找到數量較多的前哨淋巴節。

關鍵字

乳癌 ； 淋巴腺掃描 ； 前哨淋巴節 ； 鎝-99m phytate

並列摘要

Background: Sentinel lymph node biopsy detected by lymphoscintigraphy (LSG) can reduce morbidity resulting from axillary lymph nodes dissection. We wanted to know whether increasing number of injection site can increase the detected rate and number of sentinel lymph nodes (SLNs) via lymphoscintigraphy. Methods: 189 patients with breast cancer were enrolled in the Taichung Veterans General Hospital during 2008~2009. Before mapping SLNs, intradermal periareolar injections of Tc-99m phytate were performed. Group A (97 patients) received one-site injection. Group B (92 patients) received two-site injection. The detection rate and number of SLNs were evaluated by statistical methods. Results: The detection rate of SLNs by LSG in Group A and B were 96.91% and 98.97%, respectively (P = 0.31). The mean value of number of detected SLNs in groups A and B were 1.54 and 1.87, respectively (P = 0.03). Conclusions: The method of two-site injection has the tendency of increasing the detection rate of SLNs and can find more number of SLNs in patients with breast cancer.

並列關鍵字

breast cancer ； lymphoscintigraphy ； sentinel lymph nodes ； Tc-99m phytate