Thepotentialvalue In^99mTc-SC Sentinel Lymph Nodemappingfor Diagnosis And Treantment Of Patients With Cutaneous Melanoma

Objective:Detect the sentinel lymph node (SLN) ofcutaneous malignant melanoma by using radioactive drug,99mTc-SC. Explore the feasibility and effect of radionuclide imaging of sentinel lymph node imaging factors according to the results of sentinel lymph node biopsy and primary lesion pathology. Evaluate the prediction of regional lymph nodes metastasis of of cutaneous melanoma and clinical application value ofthe SLNMethods:Ninety-nine patients with Ⅰ, Ⅱ period of cutaneous malignant melanoma as subjects.Marked by the chemical synthesis method for imaging agent99mTc-SC, and carry out quality control testing. Inject the imaging agent99mTc-SC in the lesions around subcutaneous4-6h before the operation. Then take the early local imaging and delayed imaging, when necessary, with local tomography. Surface marking combined the imaging.All patients underwent sentinel lymph node biopsy, first visit patients should be treated with primary lesion resection.Pathological examination of the primary lesion and sentinel lymph node biopsy after resection.Pathology report includes detailed, lymph node metastasis, size, thickness of Breslow, Clark classification, ulcer and so on.Results:In99patients,61patients with newly diagnosed patients for biopsy,38cases have been accepted the primary lesion resection and confirmed by pathological results on the outside. Of all,90cases found in the SLN development, the total positive rate was90.9%. The detection rate was no statistical difference between gender (P=0.899) and age (P=0.704).Primary lesions were located on the extremities in83cases,16cases of trunk, the detection rate was statistical differences between extremities and trunk (P<0.001). According to the postoperative pathology, sentinel lymph node metastasis were found in26cases, the positive rate was28.9%(26/90);1case was false negative, false negative rate was3.7%(1/27), the sensitivity was96.3%(26/27); the specificity was100%.7patients (7.1%) appeared without regional lymph node drainage area development, pathology revealed there were no metastasis. It can be seen from the relationship between the sentinel lymph node metastasis and pathology, positive rate of metastatic lesions associated with ulcer, thickness of Breslow, the level of Clark grade.Conclusions:99mTc-SC sentinel lymph node imaging can accurately show the location and lymph drainage of the SLN with high sensitivity and high specificity, and can reduce drug labeling time and further improve the detection rate of sentinel lymph nodes. To provide an important clinical basis for the diagnosis and treatment decision of the of sentinel lymph node biopsy for cutaneous malignant melanoma of regional lymph nodes.