The roles of 18F-FDG-PET/CT and US-guided FNAC in assessment of axillary nodal metastases in breast cancer patients
The roles of 18F-FDG-PET/CT and US-guided FNAC in assessment of axillary nodal metastases in breast cancer patients
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DOI：
10.1007/s12282-016-0684-5
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发表时间：
2017-01-01
期刊：
影响因子：
4
通讯作者：
Minato, Hiroshi
中科院分区：
文献类型：
--
作者：
Nakano, Yasuharu;Noguchi, Masakuni;Minato, Hiroshi
术前需要采用微创技术来识别腋窝淋巴结（ALN）转移。患者接受超声检查（US）和F-18-氟脱氧葡萄糖-正电子发射断层扫描/计算机断层扫描（F-18-FDG-PET/CT），然后根据超声检查结果进行超声引导下细针抽吸细胞学检查（FNAC）和/或前哨淋巴结（SLN）活检。 ALN。随后，FNAC 阳性以及 SLN 阳性的患者接受了腋窝淋巴结清扫术（ALND）。术后，对切除的 SLN 和 ALN 进行组织学检查。 59 例腋窝 F-18-FDG 摄取阳性的患者中，50 例（85%）存在腋窝转移，但 9 例（15%）F-18-FDG 摄取结果呈假阳性。另一方面，29 名 FNAC 阳性的患者接受了 ALND，无需进行 SLN 活检，而其余 20 名 FNAC 阴性的患者以及 249 名超声结果阴性的患者接受了 SLN 活检。随后，68 名 SLN 阳性患者接受了 ALND。 腋窝 FDG 摄取阳性并不总是表明腋窝转移。超声引导下的 FNAC 可有效避免 F-18-FDG 摄取阳性患者不必要的 ALND。然而，对于超声检查 ALN 阴性和 FNAC 阴性的患者，需要进行 SLN 活检。
There is a need for less invasive techniques for preoperative identification of axillary lymph node (ALN) metastases.Patients underwent ultrasonography (US) and F-18-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18-FDG-PET/CT), and then US-guided fine needle aspiration cytology (FNAC) and/or sentinel lymph node (SLN) biopsy were performed based on the US findings of the ALNs. Subsequently, patients with positive FNAC as well as those with positive SLN underwent axillary lymph node dissection (ALND). Postoperatively, removed SLNs and ALNs were examined histologically.Fifty (85 %) of 59 patients with positive F-18-FDG uptake in the axilla had axillary metastases, but F-18-FDG uptake results were false-positive in 9 (15 %) cases. On the other hand, 29 patients with positive FNAC underwent ALND without the need for SLN biopsy, while the remaining 20 patients with negative FNAC as well as 249 patients with negative US findings underwent SLN biopsy. Subsequently, 68 patients with positive SLN underwent ALND.Positive FDG uptake in the axilla does not always indicate axillary metastasis. US-guided FNAC is useful to avoid unnecessary ALND in patients with positive F-18-FDG uptake. However, SLN biopsy is needed in patients with negative US findings of the ALNs and those with negative FNAC.