Camparison of the Efficiency for Tc-99m Tin-colloid and Tc-99m Phytate in Sentinel Node Detection in Breast Cancer Patients

유방암 환자의 전초림프절 검사에서 Tc-99m Tin-colloid와 Tc-99m Phytate의 효용성에 대한 비교

  • Seok, Ju-Won (Department of Nuclear Medicine, College of Medicine, Chung-Ang University) ;
  • Kim, In-Ju (Department of Nuclear Medicine, College of Medicine, Pusan National University)
  • 석주원 (중앙대학교병원 핵의학과) ;
  • 김인주 (부산대학교병원 핵의학과)
  • Published : 2008.12.31

Abstract

Purpose: Lymphoscintigraphy and sentinel node biopsy has become a standard method for detection of axillary lymph node metastasis in breast cancer patients, but the standard radiopharmaceutical was not prepared. About detection of axillary lymph node metastasis by lymphoscintigraphy and sentinel node biopsy in breast cancer patient, we compared the results of Tc-99m Tin-colloid and Tc-99m Phytate by subareolar injection. Materials and Methods: This study included 382 breast cancer patients who were performed operation during 2001-2008. Three hundred forty nine patients was injected 0.8ml of Tc-99m Tin-colloid (37-185 MBq) by subareolar injection. Thirty three patients was injected 0.8ml of Tc-99m Phytate (37-185 MBq). Lymphoscintigraphy was performed in supine position and sentinel node localization was performed by hand-held gamma probe in operation. Result: Among 349 patients by Tc-99m Tin-colloid, 312 cases (89.4%) localized the sentinel node by lymphoscintigraphy, 304 cases (87.1%) localized by gamma probe. Among 33 patients by Tc-99m Phytate, 32 cases (97.0%) localized by lymphoscintigraphy, 33 cases (100%) localized by gamma probe. Detection rate by lymphoscintigraphy and gamma probe was superior for Tc-99m Phytate compared to that with Tc-99m Tin-colloid, with a statistically significant difference. (p<0.05, p<0.05) Conclusion: Tc-99m Phytate is a better choice for localization of sentinel node than Tc-99m Tin-colloid in breast cancer patients.

목적 : 전초림프절 스캔과 전초림프철 생검은 유방암 환자에서 액와림프절 전이를 인지하기 위한 표준화된 방법으로 사용되게 되었지만, 표준화된 방사성의약품은 마련되어 있지 않다. 액와림프절 전이를 인지하기 위한 전초림프절 검사에 있어서 본 연구에서는 Tc-99m Tin-colloid와 Tc-99m Phytate의 결과를 비교하여 보았다. 대상 및 방법: 본 연구에서는 2001년에서 2008년까지 유방암으로 수술을 시행했던 381명의 환자를 대상으로 하였다. 349명의 환자는 Tc-99m Tin-colloid (37-185MBq) 0.8ml를 유륜하로 주사하였다. 33명의 환자는 Tc-99m Phytate (37-185 MBq) 0.8 ml를 유륜하로 주사하였다. 앉은 자세에서 림프신티그라피가 시행되었고, 수술 중에 감마프로브로 전초림프절을 발견하였다. 결과: Tc-99m Tin-celloid로 검사를 시행한 전체 349명의 환자 중에서 312명(89.4%)이 림프신티그라피에 의해 전초림프절이 발견되었고, 304명(87.1%)이 감마프로브에 의해 전초림프절이 발견되었다. 전날검사를 시행한 전체 33명의 환자 중에서 32명(97.0%)이 림프신티그라피에 의해 전초림프절이 발견되었고 33명(100%)이 감마프로브에 의해 전초림프절이 발견되었다. Tc-99m Phytate에 의한 림프신티그라피와 감마프로브에 의한 전초림프절 발견율은 Tc-99m Tin-celloid와 비교하여 통계학적으로 유의하게 높았다 (p<0.05, P<0.05). 결론: 유방암 환자에서 전초림프절을 발견하는데 있어 Tc-99m Phytate가 Tc-99m Tin-colloid보다 더 좋은 선택일 것이다.

Keywords

References

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