Lymphoscintigraphy with radio-colloidal agent

(材料与方法)对30例口腔癌患者进行了放射性核素显像和FDG正电子发射计算机断层扫描。采用核素淋巴显像和正电子发射计算机断层扫描(PET)检测淋巴结转移情况。在淋巴核素扫描中，选择了两个注射区域。一种是耳后颈部淋巴结的口腔外皮下区域。另一种是上磨牙区粘膜皱褶的口腔内粘膜下区，用于下颌下淋巴结。分别于两侧各注射0.25ml37MBq的放射性胶体。注射后立即用伽玛相机进行扫描。PET组静脉注射3.7MBq/kg的FDG，注射后40min进行扫描。此外，在活检或手术后获得的肿瘤样本被石蜡包埋并切成薄片，用于葡萄糖转运蛋白的免疫组织化学染色。淋巴组织中NO-…的蓄积将更多的DES分为三组，在正电子发射计算机断层扫描中分别评定为三级。免疫组织化学染色肉眼可分为三级。(结果)在PET扫描中，约75%的转移淋巴结被发现。但其检出依赖于淋巴结的大小，小淋巴结难以检出(5%以下)。SUV在各淋巴结中的分布范围为2~6个，分布广泛。核素淋巴显像显示转移淋巴结呈斑点状、绳状、缺损型三种图像。这些图像分别与病理表现密切相关。在葡萄糖转运体免疫组织化学染色中，所有转移性淋巴结均呈中度至重度染色。(结论)放射性胶体核素淋巴显像和FDG正电子发射计算机断层扫描是诊断较大转移性淋巴结的有效方法。然而，这些方法对于小转移性淋巴结是无能为力的。因此，我们将做进一步的评估，以建立一种检测微小转移淋巴结的技术。较少

(Materials ＆ Methods) Patients with oral cancer were examined by the scintigraphy with Tc-radio-colloid and PET with FDG. To detect lymph node metastasis, lymphoscintigraphy and PET scan were performed. In lymphoscintigraphy, two areas of injection were selected. One is the extra-oral subcutaneous area behind the ear for the cervical lymph nodes. The other is the intra-oral sub mucosal area of mucobuccal fold of the upper molar region for the submandibular lymph nodes. The radio-colloid in each volume of 0.25 ml (37MBq) was injected in both sides of each area respectively. Scanning was done immediately after injection with Gamma camera. In PET, FDG of 3.7MBq/kg was injected intravenously and the scanning was done after 40 min from the injection. Furthermore, the tumor samples, obtained either after the biopsy or after the operation, were embedded in paraffin wax and cut into thin sections for the immunohistochemical staining of the glucose transpototer. The accumulation of the lymph no … More des was evaluated into three groups and in PET scanning was evaluated into three grades respectively. The immunohistochemical staining was also evaluated into three grades visually. (Results) In PET scanning, around 75% of metastatic lymph nodes were detected. But, the detection strongly depended upon the size of lymph nodes and small lymph nodes were hardly detected (under 5%). The SUV ranged from 2 to 6 among lymph nodes and distributed widely. In lymphoscintigraphy, metastatic lymph nodes showed three images of defect, mottled and rope-like appearances. These images showed a close correlation with the pathologic manifestations respectively. In immunohistochemical staining of the glucose transporter, all metastatic lymph nodes showed from a moderate to a severe staining. (Conclusions) Lymphoscintigraphy with radio-colloida: agent and PET scanning with FDG were useful for the detection of metastatic lymph nodes of relatively large size. However, these methods were helpless for the small metastatic lymph nodes. Therefore, we will make a further evaluation to establish a technique for the detection of the small metastatic lymph nodes. Less