Sentinel lymph node in carcinoma of the thoracic esophagus

背景：应用~(99m)Tm胶体硫化铼对胸段食管鳞癌前哨淋巴结的检测进行了评价。手术前一天，在原发灶周围的4个部位将~(99m)Tm胶体硫化Re注入黏膜下层。进行淋巴放射性核素扫描。注射99m后23h行食道切除术和根治性淋巴结清扫术。结果：40%的患者(4/10)发现了前哨淋巴结。10例患者中9例术后伽玛刀检出前哨淋巴结。前哨淋巴结数目为1~9个，存在前哨淋巴结的淋巴站点数目为1~7个。3例有淋巴结转移的患者，阳性结节均未显示放射性。前哨淋巴结类型与临床病理因素的比较无统计学意义。结论：99m胶体硫化Re淋巴标测不能用于前哨淋巴结定位。淋巴标测技术的改进和努力是必要的。

Background : We assessed the detection of sentinel lymph nodes in patients with squamous cell carcinoma of the thoracic esophagus using technetium-99m colloidal rhenium sulfide.Methods : We observed 10 patients with thoracic esophageal carcinomas who underwent radical esophagectomy. The day before surgery, technetium-99m colloidal rhenium sulfide was injected into submucosa at four sites around the primary tumor. Lymphoscintigraphy was performed. Esophagectomy and radical lymph node dissection were performed 23 hours after the technetiunr99m injection. After surgery, the radioactivity of the resected lymph nodes was evaluated by the gamma probe.Results : Lymphoscintigraphy detected sentinel lymph nodes in 40% of the patients (4 of 10 patinets). In 9 of 10 patients, sentinel lymph nodes were detected by the gamma plobe after surgery. The number of sentinel lymph nodes was one to nine, and the number of lymph node stations existing sentinel lymph nodes was one to seven. In 3 patients with lymph node metastasis, positive nodes did not show the radioactivity. A comparison of the pattern of sentinel lymph nodes and clinicopathologic factors showed no siginificant association.Conclusions : We could not show that the lymphatic mapping with technetium-99m colloidal rhenium sulfide was available. The improvement and effort of lymphatic mapping technique are necessary.