CAJ | 학술논문

目的评价SPECT-CT淋巴显像探测喉癌患者前哨淋巴结(SLN)的价值.方法 30例临床N0期喉癌患者,术前于喉镜引导下注射99Tcm-硫胶体(SC),使用SPECT-CT进行SLN显像;同时,术中用γ探测仪探测放射性"热点".将手术切除的SLN及颈清扫标本行病理检查.结果全组30例检出SLN 28例,检出率为93.3%.术前平面显像、SPECT-CT分别检出61个和66个SLN.术中用手持式γ探测仪有27例患者探测到SLN,共计70个,检出率为90.0%(27/30).γ探测仪探测SLN数目与SPECT-CT淋巴显像数目有4例不一致,24例符合,其符合率为85.7%(24/28).病理结果显示,6例患者有淋巴结转移,占20.0%.SLN检测的灵敏度、特异度、准确率和假阴性率分别为83.3%、95.8%、93.3%和16.7%.结论术前SPECT-CT淋巴显像能有效探测喉癌患者的SLN,准确预测颈部淋巴结转移情况.
목적 평개SPECT-CT림파현상탐측후암환자전초림파결(SLN)적개치.방법 30례림상N0기후암환자,술전우후경인도하주사99Tcm-류효체(SC),사용SPECT-CT진행SLN현상;동시,술중용γ탐측의탐측방사성"열점".장수술절제적SLN급경청소표본행병리검사.결과 전조30례검출SLN 28례,검출솔위93.3%.술전평면현상、SPECT-CT분별검출61개화66개SLN.술중용수지식γ탐측의유27례환자탐측도SLN,공계70개,검출솔위90.0%(27/30).γ탐측의탐측SLN수목여SPECT-CT림파현상수목유4례불일치,24례부합,기부합솔위85.7%(24/28).병리결과현시,6례환자유림파결전이,점20.0%.SLN검측적령민도、특이도、준학솔화가음성솔분별위83.3%、95.8%、93.3%화16.7%.결론 술전SPECT-CT림파현상능유효탐측후암환자적SLN,준학예측경부림파결전이정황.
Objective To evaluate the value of SPECT-CT lympheseintigraphy for sentinel lymph node (SLN) detection in patients with larynx neoplasms. Methods Thirty patients with cN0 laryngeal carcinoma were eligible for the study. Preoperative SPECT-CT lymphoscintigraphy was performed with laryngutracheoscopy guided injection of radioactivity isotope 99Tcm-sulfur colloid (99Tcm-SC) into the laryngeal carcinoma before surgery. The patients underwent intraoperative lympbatic mapping with a handheld gamma-detecting probe. The results of routine pathologic examination of cervical specimen were set a golden standard to assess the efficacy of SLN biopsy in evaluating the cervical lymph node status. Results Sixty-six SLNs were detected in 28 cases out of the total 30 cases (93.3%). Preoperative planar image and SPECT-CT fusion image detected 61 and 66 SLNs, respectively. With the application of intraoperative gamma probe, SLN was detected in 27/30 patients (90.0%), correlate rate was 85.7% (24/28). Six patients (20.0%) had lymph node metastasis. The sensitivity, specificity, accuracy and false negative rate of SLN detection were respectively 83.3%, 95.8%, 93.3% and 16.7%. Conclusion Preoperative SPECT-CT lymphescintigraphy can not only enables precise localization of SLN but also detect the cervical lymph node metastasis in patients with laryngeal carcinoma.