Lymphoscintigraphy with radio-colloidal agent

（材料与方法）对口腔癌患者进行ct放射胶体显像和FDG PET显像检查。行淋巴显像和PET扫描检查淋巴结转移。在淋巴显像中，选择两个注射区域。一个是耳后的口外皮下区域颈部淋巴结。另一个是下颌下淋巴结的上磨牙区粘膜颊襞的口腔内粘膜下区。每体积0.25 ml （37MBq）的放射性胶体分别注射于每个区域的两侧。注射后立即用伽马照相机进行扫描。PET中，静脉注射3.7MBq/kg的FDG，注射后40分钟扫描。此外，将活检后或手术后获得的肿瘤样本包埋于石蜡中，切成薄片，对葡萄糖转座蛋白进行免疫组化染色。在PET扫描中，将淋巴结的积聚分为3组，并将其分为3个等级。免疫组化染色在视觉上分为三个等级。（结果）PET扫描显示约75%的转移性淋巴结。但其检出率主要依赖于淋巴结的大小，小淋巴结几乎未检出（小于5%）。淋巴结中SUV数在2 ~ 6之间，分布广泛。在淋巴显像中，转移性淋巴结表现为三幅缺陷，斑驳和绳状外观。这些图像分别与病理表现密切相关。在葡萄糖转运蛋白免疫组化染色中，所有转移性淋巴结均显示中度至重度染色。（结论）放射性胶体剂淋巴显像和FDG PET扫描对较大转移性淋巴结的检测是有效的。然而，这些方法对小转移淋巴结无效。因此，我们将进一步评估建立一种检测小转移淋巴结的技术。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