Predicting sentinel lymph node metastasis in breast cancer with lymphoscintigraphy
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概要
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Objective Lymphoscintigraphy is an effective method for detecting sentinel lymph nodes (SLNs). However, the rate and degree of SLN detection is not uniform. We quantified SLNs detected with lymphoscintigraphy, and investigated correlations with factors that may influence detection. We then attempted to predict SLN metastasis from lymph node counts, comparing the predictions to subsequent biopsy results. Methods We assessed lymph node counts in 100 breast cancer patients in whom a single SLN was detected with a fixed lymphoscintigraphy procedure. We examined correlations between the counts and factors known to influence lymphoscintigraphic SLN detection (age, body mass index, tumor size, and presence or absence of metastasis), and determined reference values (lymph node counts of 10.0, 19.4 and 53.0) which were used to predict SLN metastasis in 100 subsequent patients. The predictions were then compared with the SLN biopsy findings. Results SLN counts correlated strongly with the presence or absence of metastasis, with metastasis-positive lymph nodes showing significantly lower counts than negative nodes (p\0.001). Prediction of SLN metastasis achieved a 100% positive predictive value at a reference value of 10.0, and a 100% negative predictive value at a reference value of 53.0. At a reference value of 19.4, the sensitivity, specificity, and diagnostic accuracy were 77.8, 73.2, and 74.0%, respectively. Conclusions The SLN counts detected with lymphoscintigraphy were significantly lower in metastasis-positive lymph nodes than in metastasis-negative lymph nodes. This suggests that prediction of SLN metastasis in breast cancer is possible using lymphoscintigraphy. © The Japanese Society of Nuclear Medicine 2010.
- Springer Verlag (Germany)の論文
- 2011-04-01
著者
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Noguchi Atsushi
Department Of Applied Chemistry Faculty Of Science And Engineering Waseda University
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ONOGUCHI Masahisa
Department of Health Science, School of Medicine, Kanazawa University
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Motomura Kazuyoshi
Department Of Breast And Endocrine Surgery Osaka Medical Center For Cancer And Cardiovascular Diseas
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Motomura Kazuyoshi
Department Of Surgery Osaka Medical Center For Cancer And Cardiovascular Diseases
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KATSUDA TOSHIZO
Department of Health Sciences, Okayama University of Medical School
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Noguchi Atsushi
Department Of Nuclear Medicine Osaka Medical Center For Cancer And Cardiovascular Diseases
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OHNISHI Takeshi
Department of Nuclear Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases
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Ohnishi Takeshi
Department Of Agricultural Chemistry Faculty Of Agriculture Kyushu University:(present Address) Kane
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Ohnishi Takeshi
Department Of Nuclear Medicine Osaka Medical Center For Cancer And Cardiovascular Diseases
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Hashizume Terumi
Department Of Nuclear Medicine Osaka Medical Center For Cancer And Cardiovascular Diseases
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Katsuda Toshizo
Department Of Radiological Technology Seikeikai College Of Medical Technology
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KAJITA Akiyoshi
Department of Nuclear Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases
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FUNAUCHI Masahiro
Department of Nuclear Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases
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Kajita Akiyoshi
Department Of Nuclear Medicine Osaka Medical Center For Cancer And Cardiovascular Diseases
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Funauchi Masahiro
Department Of Nuclear Medicine Osaka Medical Center For Cancer And Cardiovascular Diseases
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Onoguchi Masahisa
Department Of Quantum Medical Technology Division Of Health Sciences Kanazawa University Graduate Sc
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