Sentinel Node Identification Using Technetium-99m Neomannosyl Human Serum Albumin in Esophageal Cancer
Sentinel Node Identification Using Technetium-99m Neomannosyl Human Serum Albumin in Esophageal Cancer
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DOI：
10.1016/j.athoracsur.2011.01.016
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发表时间：
2011-05-01
影响因子：
4.6
通讯作者：
Choi, Young Ho
中科院分区：
文献类型：
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作者：
Kim, Hyun Koo;Kim, SeungEun;Choi, Young Ho
背景。本研究是一项临床试验，旨在测试使用一种新的甘露糖受体放射性结合剂在食管鳞状细胞癌患者中检测前哨淋巴结的可靠性和可行性。入选23例（21男2女，平均年龄61.0±8.60岁）食管切除术合并常规淋巴结清扫的胸段食管癌患者。术前约1小时，在食管镜引导下，将总剂量为1mCi (99m)Tc-MSA[锝-99m新马糖醇人血清白蛋白]0.2 mL分4个象限注入原发肿瘤周围的粘膜下层。术中前哨淋巴结取样后进行食管切除术。所有淋巴结被切成2mm切片，最终用福尔马林固定切片和石蜡包埋切片，苏木精和伊红染色进行诊断。每例患者淋巴结清扫数为30.5±9.18（15-47）。在23例患者中，有21例（91.3%）患者能识别前哨淋巴结。所有21例cT1或T2N0M0患者（100%）均可发现前哨淋巴结；这些患者是食管癌前哨淋巴结导航手术的候选者。发现的前哨淋巴结平均数目为每位患者2.6 +/- 1.35（范围，1-5）。8例淋巴结阳性患者未检出假阴性前哨淋巴结（0%）。（99m）Tc-MSA在食管鳞状细胞癌患者术中前哨淋巴结识别是可行和可靠的。
Background. This study is a clinical trial designed to test the reliability and feasibility of sentinel node detection using a new mannose receptor radioactive binding agent in patients with esophageal squamous cell carcinoma.Methods. Twenty-three patients (21 men, 2 women; mean age 61.0 +/- 8.60 years) who were candidates for esophagectomy with conventional lymph node dissection for thoracic esophageal cancer were enrolled. A total dose of 1mCi of (99m)Tc-MSA [technetium-99m neomannosyl human serum albumin] in 0.2 mL was administered at 4 quadrants into the submucosal layer around the primary tumor under esophagoscopic guidance approximately 1 hour before surgery. Intraoperative sentinel node sampling was subsequently followed by esophagectomy. All harvested lymph nodes were cut into 2-mm slices and ultimately diagnosed using formalin-fixed and paraffin-embedded sections with hematoxylin and eosin staining.Results. The number of dissected lymph nodes per patient was 30.5 +/- 9.18 (15-47). Among 23 patients, the sentinel lymph nodes could be identified in 21 patients (91.3%). The sentinel nodes could be identified in all 21 patients with cT1 or T2N0M0 (100%) disease; these patients were candidates for sentinel lymph node navigation surgery for the esophageal cancer. The mean number of sentinel nodes identified was 2.6 +/- 1.35 (range, 1-5) per patient. No false-negative sentinel lymph nodes were detected in any of the 8 patients with node-positive disease (0%).Conclusions. Intraoperative sentinel lymph node identification using (99m)Tc-MSA was feasible and reliable in patients with esophageal squamous cell carcinoma.