Lymphoscintigraphy in sentinel lymph node biopsy of breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility of lymphoscintigraphy in sentinel lymph node biopsy of breast cancer.</p><p><b>METHOD</b>Lymphoscintigraphy was performed after peritumoral or subdermal injection of radioactive colloid. Then, sentinel lymph node (SLN) biopsy guided by gamma detector probe was performed. Factors correlated with identification-detection rate were assessed.</p><p><b>RESULTS</b>Lymphatic drainage was present in preoperative lymphoscintigraphy in 88(93%) out of 95 patients, with 39 (44.3%) positive for lymphatic drainage other than in the axilla. A total of 91 (95.8%) patients had their SLN identified in the intraoperative procedure. The quality of lymphoscintigraphic image was closely related to SLN identification-detection rate in the intraoperative procedure (P = 0.025).</p><p><b>CONCLUSION</b>Sentinel lymph node outside the axilla can be detected by lymphoscintigraphy. The combination of lymphoscintigraphy and gamma detector probe for sentinel lymph node biopsy of breast cancer not only is acceptable but promising.</p>

The clinical value of mammary sentinel lymphoscintigraphy in breast cancer / 中国癌症杂志

Purpose: To evaluate the clinical value of mammary sentinel lymphoscintigraphy in breast cancer. Methods: 91 patients with breast cancer in stage T1-2N0 were injected with 55. 5MBq/0. 5ml 99mTc- human serum albumin on the surface of the lesion subdermally or 92. 5MBq/4ml unfiltered 99mTc-sulfur colloid in four divided doses around the lesion. 63 patients underwent mammary lymphoscintigraphy and sentinel node biopsy using a hand-held r-ray detector probe were performed 2 - 16 hr postinjection in 70 patients during breast surgery . Results: The sentinel lymph node( s) (SLN) could quickly be shown by these two tracers in 81% (51/63) cases . A SLN with low activity could be seen in 13. 7% (7/5.1) cases , in which 85.7%(6/7) were proved to have a metastasis. Lymph drainage to the internal mammary nodes occurred in 38. 5% (5/13) of patients with an inner-lesion and in 26. 3% (10/38) of patients with an outer-lesion . The SLN was successfully identified in 95. 7% (67/70) of the patients and the number of the nodes ranged from 1 -5 with an average 1. 6 per person . The accuracy of the SLN with respect to the positive or negative status of the axillary nodes was 92.53% (62/67) . The sensitivity , specificity, PPV, NPV of the method was 82.75% (24/29), 100% (38/38), 100% (24/24) and 88. 37% (38/43), respectively . Conclusions: Mammary lymphoscintigraphy in breast cancer is helpful for localizing SLN correctly and identifying abnormal lymph drainage.

Lymphoscintigraphy for lateral lymph node drainage in low rectal cancer / 中国普通外科杂志

ObjectiveTo assess the diagnostic value of preoperative lymphoscintigraphy for lateral lymph node metastasis in low rectal cancer. MethodsFrom May 1999 to March 2001, pelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid was performed on 32 patients with proven colorectal cancer one day prior to operation. Among these patients were 27 rectal cancers, 3 sigmoid cancers and 2 colon cancers. Fifteen cases of rectal cancer with the tumor located at or below the peritoneal reflection received extended lymphadenectomy with lateral dissection (D3 lymphadenectomy). The result of lymphoscintigrams was correlated with histologic lateral node examination. Results The image ratio of pararectal nodes, obturator nodes, and internal iliac aorti lymph trains was 69%, 91%, and 100% respectively. In 15 patients receiving D3 lymphadenectomy, 10 had negative lymphoscintigrams whereas 5 had positive image, and the lateral pathology positive rate was 13%(2/15). Analysis of these results revealed the sensitivity (100%), specificity (77%) and accuracy (80%) of this diagnostic method. ConclusionPelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid could demonstrate the lateral lymph node drainage of low rectal cancer, and the correlation with postoperative histologic lateral node examination was high enough to enable surgeons to adopt an individualized surgical approach.