Determination of sentinel lymph nodes in gynecological cancer using the radiopharmaceutical Sentiscan. A case series

Q4 Medicine
A. Shevchuk, A. Krylov, R. I. Knyazev, Kristina V. Afanasieva
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引用次数: 0

Abstract

Background. Lymphadenectomy in patients with malignant female genital neoplasms is a necessary step of surgical treatment, the implementation of which allows assessing the the metastatic involvement of the removed lymph nodes and determining indications for postoperative treatment. Sentinel lymph node (SLN) biopsy with ultrastaging method appears to be a good alternative to standard regional lymph node removal with similar long-term oncologic outcomes and significantly lower rates of postoperative complications. Aim. To present the possibility of using a domestic radiopharmaceutical labeled with technetium-99m (Sentiscan) in patients with gynecological cancer. Materials and methods. A series of clinical cases of the use of Sentiscan during SLN biopsy in three patients suffering from cancer of the uterus and vulva is presented. Results. 1824 hours before the operation, 0.4 ml of the prepared solution of radiopharmaceutical 99mTc-Sentiscan with a total activity of 150 MBq was injected into the cervix of the uterus with tumors of the uterine body and into the vulva. After 2 hours, SPECT/CT was performed on the Discovery 670 DR (GE) of the abdomen and pelvis, followed by 3D reconstruction of images for better intraoperative navigation. Intraoperatively, a portable gamma detector Rad Pointer Gamma (Medikor Pharma Ural) was used to identify sentinel lymph nodes. Sentinel lymph nodes were removed in all patients, followed by a control assessment of the gamma radiation level, histological and immunohistochemical studies using panCK, CK18 markers. Conclusion. Presented clinical cases demonstrated high efficacy of sentinel lymph node mapping using radiopharmaceutical Sentiscan. Further studies are necessary for wide implementation of this technology in clinical practice.
应用放射药物Sentiscan检测妇科肿瘤前哨淋巴结。案例系列
背景。女性生殖器恶性肿瘤患者的淋巴结切除术是手术治疗的必要步骤,其实施可以评估切除淋巴结的转移累及情况,并确定术后治疗的指征。前哨淋巴结(SLN)活检与超声扫描法似乎是一个很好的替代标准的区域淋巴结切除,具有相似的长期肿瘤预后和显著降低术后并发症的发生率。的目标。介绍国产锝-99m标记放射性药物Sentiscan用于妇科肿瘤治疗的可能性。材料和方法。本文介绍了三例子宫和外阴癌患者在SLN活检中使用Sentiscan的一系列临床病例。结果:术前1824小时,将制备的总活性为150mbq的放射性药物99mTc-Sentiscan溶液0.4 ml注射于子宫体肿瘤的子宫颈及外阴内。2小时后,对腹部和骨盆的Discovery 670 DR (GE)进行SPECT/CT扫描,然后进行三维图像重建,以便更好地进行术中导航。术中使用便携式伽马探测器Rad Pointer gamma (Medikor Pharma Ural)来识别前哨淋巴结。所有患者的前哨淋巴结均被切除,随后进行伽马辐射水平的对照评估,使用panCK, CK18标记物进行组织学和免疫组织化学研究。结论。所提出的临床病例表明,使用放射性药物Sentiscan进行前哨淋巴结定位具有很高的疗效。为了在临床实践中广泛应用该技术,需要进一步的研究。
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来源期刊
Journal of Modern Oncology
Journal of Modern Oncology Medicine-Oncology
CiteScore
0.50
自引率
0.00%
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0
审稿时长
5 weeks
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