利用放射性示踪剂注射对喉癌进行术中淋巴测绘和前哨节点活检。

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Annals of Nuclear Medicine Pub Date : 2024-06-04 DOI:10.1007/s12149-024-01948-y
Pegah Sahafi, Amin Saber Tanha, Maryam Daghighi, Ehsan Khadivi, Kamran Khazaeni, Dabbagh Kakhki Vahid Reza, Ramin Sadeghi
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引用次数: 0

摘要

研究目的本研究旨在确定喉鳞癌前哨淋巴结活检(SLNB)的价值,采用术中肿瘤周围注射 Tc-99m-phytate 的方法:方法:纳入经活检证实的喉鳞状细胞癌患者。手术当天,麻醉诱导后进行悬吊喉镜检查,将 74 MBq/0.4 ml Tc-99m-phytate 分四等分注射到粘膜下肿瘤周围位置。等待 10 分钟后,使用便携式伽马探针定位前哨节点。随后,所有患者都接受了喉切除术和颈部切除术。使用苏木精和伊红(H&E)染色法检查前哨结节和非前哨结节:研究共纳入 26 名确诊为喉癌的患者。SLN检出率为65.4%,其中声门上区检出率为100%,声门/跨声门患者检出率为52.6%。永久病理结果显示有四名患者淋巴结受累,但只有一名患者的 SLNB 结果为阴性,因此总体假阴性率为 25%。SLN技术的总体灵敏度为75%,声门上区为100%,声门/声门区为67%:结论:SLNB的准确性和可行性可能与肿瘤在喉部的位置有关。对于声门上的肿瘤,该技术似乎是可行的,假阴性率较低。对于声门/声门后肿瘤,检测率和假阴性率似乎都不理想。我们还需要进一步的研究来验证我们的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Intra-operative lymphatic mapping and sentinel node biopsy in laryngeal carcinoma using radiotracer injection

Objective

The purpose of this study was to determine the value of sentinel lymph node biopsy (SLNB) in the laryngeal SCC, using intra-operative peri-tumoral injection of Tc-99m-phytate.

Methods

Patients with biopsy-proven squamous cell carcinoma of the larynx were included. On the day of surgery, after anesthesia induction, suspension laryngoscopy was performed to inject 74 MBq/0.4 ml Tc-99m-phytate in four aliquots into the sub-mucosal peri-tumoral location. After a 10-min wait, a portable gamma probe was used to locate sentinel nodes. Subsequently, all patients underwent laryngectomy and neck dissection. Both sentinel nodes and non-sentinel nodes were examined using hematoxylin and eosin (H&E) staining.

Results

Twenty-six patients with a diagnosis of laryngeal carcinoma were included in the study. The SLN detection rate was 65.4%, with a 100% detection rate in the supraglottic region and a 52.6% detection rate for glottis/transglottic patients. Permanent pathology results showed lymph node involvement in four patients, but only one patient had a negative result in the SLNB, resulting in an overall false negative rate of 25%. The sensitivity of the SLN technique was 75% overall, 100% in the supraglottic region, and 67% in the glottis/transglottic region.

Conclusion

The accuracy and feasibility of SLNB may be related to the location of the tumors in the larynx. For supraglottic tumors, the technique seems to be feasible with a low false negative rate. For glottis/transglottic tumors, both the detection rate and false negative rate seem to be suboptimal. Further studies are needed to validate our results.

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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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