使用放射性药物 99mTc-sentiskan 观察乳腺癌患者前哨淋巴结的亲身经历

R.I. Tamrazov, R.D. Khusnutdinov, E.N. Alekhin, N.V. Averina, Yu.S. Pyshkina, D.А. Pashkov
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摘要

目的:研究新型放射性药物 99mTc-sentiscan 在乳腺癌患者前哨淋巴结显像中的应用。材料与方法对 178 名确诊为乳腺癌的患者进行调查。根据放射性药物的给药途径将患者分为两组。在手术治疗前一天,所有受试者均使用注射器注射放射性药物,注射剂量为 0.3-0.4 毫升,活性不超过 120 MBq。使用专利装置 "放射性核素显像时前哨淋巴结外部标记装置 "在皮肤上标记显像前哨淋巴结。术中使用伽马探测器 Gamma-Finder II 或 Radical 寻找前哨淋巴结,然后进行紧急组织学检查。结果使用国产放射性药物 99mTc-sentiscan 对前哨淋巴结进行放射性同位素显像:第一组(瘤周给药)显像率为 100%,平均显像淋巴结数为 2.2 个;第二组(乳晕下给药)显像率为 99.1%,平均显像淋巴结数为 2.6 个。第一组患者中有 8 例(13.1%)发现前哨淋巴结转移病灶,第二组有 14 例(11.9%)。所有淋巴结均位于肿瘤进程一侧的腋窝区域。结论研究评估了使用放射性药物 99mTc-sentiscan 对乳腺癌患者前哨淋巴结进行识别和活检的可能性。使用国产 99mTc-sentiscan 可以观察到乳腺癌患者的前哨淋巴结,并在 99.1%-100% 的病例中检测到其位置。考虑到所获得的结果、放射性药物使用适应症的扩大以及试剂盒的成本,99m锝-sentiscan 更适合用于临床实践。
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Own Experience of using the Radiopharmaceutical 99mTc-sentiskan in Visualization of Sentinel Lymph Nodes in Patients with Breast Cancer
Purpose: To study the capabilities of the new radiopharmaceutical 99mTc-sentiscan in the visualization of sentinel lymph nodes in patients with breast cancer. Material and methods: A survey of 178 people diagnosed with breast cancer. Patients were divided into two groups depending on the route of administration of the radiopharmaceutical. The day before surgical treatment, all subjects were injected with a radiopharmaceutical using a syringe with an activity of no more than 120 MBq, in a volume of 0.3‒0.4 ml. The visualized sentinel lymph nodes were marked on the skin using a patented device – «Device for external marking of sentinel lymph nodes during radionuclide visualization». Intraoperative search for sentinel lymph nodes was carried out using gamma detectors Gamma-Finder II or Radical, followed by urgent histological examination. Results: Radioisotope visualization of sentinel lymph nodes using the domestic radiopharmaceutical 99mTc-sentiscan: in the first group (the drug was administered peritumorally) was 100 %, the average number of visualized lymph nodes in this group was 2.2; in the second group (the drug was administered subareolarly) ‒ 99.1 %, the average number of visualized lymph nodes ‒ 2.6. In the first group of patients, metastatic lesions of sentinel lymph nodes were detected in 8 cases (13.1 %), and in the second group ‒ in 14 (11.9 %). All lymph nodes were mapped in the axillary region on the side of the tumor process. Conclusion: The possibility of the radiopharmaceutical 99mTc-sentiscan for the identification and biopsy of sentinel lymph nodes in patients with breast cancer was assessed. The use of the domestic 99mTc-sentiscan makes it possible to visualize sentinel lymph nodes in patients with breast cancer and detect their location in 99.1‒100 % of cases. Taking into account the results obtained, the expanded indications for the use of the radiopharmaceutical and the cost of the kits, 99mTc-sentiscan is more preferable for use in clinical practice.
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来源期刊
Medical Radiology and Radiation Safety
Medical Radiology and Radiation Safety Medicine-Radiology, Nuclear Medicine and Imaging
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