Abdullah ERDOĞAN, Alpay SARPER, Levent DERTSİZ, Arife ZEYBEK, Abid DEMİRCN

Küçük hücreli dışı akciğer kanserlerin detc 99m ile sentinel lenf nodunun saptanması

Giriş: Bu prospektif çalışmayla sentinel lenf nodları ve me diastina l lenf no d h aritası b e lirlenere k opera bl küçü k h ücre li dışı a kc iğe rkc k arsinoma ların da gerçe k no d evre lemesi yapılmas ı amaçlan dı. Materya l ve Meto d : Opera bl k üçü k h ücre li dışı b ron ş karsinomu ne deniyle a kciğer reze k siyonu uy gu lanan 12 h asta ara ştırmaya da h ild edildi. İntrao peratif peritümöral dokuy a T c99m en je k te e dilere k orta lama 96 da kika sonra porta bl gama sayacıyla peritümöra l ddo ku d ve lenf nodların ın ra dyoa ktivitesi ö lçüldü. Hasta lar preoperatif b ron kosk opiy le en do b ron şiya l lezyon aç ısın dan de ğerlen dirildi. T üm T hastalar preoperatif evreleme amacıyla solid organ metastaz ına yönelik tarandı. B ulgular: En sık sentinel lenf nodları %45 oran ında interlobar lenf nod istasyonlarında sa ptandı. Loblara spesifik lenf nod istasyo nla -o rı ve sk ip metastaz sa ptanan lenf no dları b e lirlen di. Sentine l lenf no du; h asta ların %77 sin de N1 düze yin de, %66 oran ın daa Nda 2 düze yin de ydi. Hasta ların %66 s ın da iki a y rı istasyon da, %33ünde te k istasy onda ydı. Sentine l lenf no du sa ptanan 9 hasta n ın 1 n ı (%11)in de rutin h istopato lojik ince lemey le metastaz raporlan dı. Sonuç: Sentine l lenf no dunun saptanması, mikrometastaz açısın dan da h a ayrıntılı pato lo jik ince leme yapılmasına o lana k sa ğlar. a ğ Küçük hücreli dışı akciğer kanserli olgularda gerçek nod evrelemenin yapılmasın ı ve sonuçta postoperatif uygun destek tedav isininis düzen lenmesini sağlar.

Determination of sentinel lymph node by tc99m in small-cel lung cancer

In troductio n : In th e pros pective stu dy was aime d to b e th e actua ln o de staging identifie d sentine l an d me diastine l lymph no des an dmappin g in patient with opera ble non-sma ll ce ll lung carcinomas.Materials and Methods: Twe lve patients un derwent pulmonary resections due to non-small ce ll bronc h ial carcinoma in th e studywere inc lude d . Intraoperatively, by in jectin g Tc 99m to peritumoral tissues, avera ge 96 minutes later, radioactivity leve ls of th etumoral tissue an d lym ph nodes were measured. All patients were eva luated by bronch oscopy for en dobronch ial lesions. Th epatients were scanned for th e metastasis of solid or gans in order to pre-operative sta gin g.Results: Th e interlobar lym ph node stations as a sentinel lym ph nodes were detected in 45% of th e patient. Lobes of s pecific, lym phnode stations and skip metastasis detecte d lym ph nodes were identified. Sentine l lym ph node was in 77% of patients at th e leve l N1an d in 66%of patients at th e leve l N2. It were at two different stations in 66% of patients an d at single-station in 33% of patient . In1 (11%) of 9 patients identified sentinel lymph node, the metastasis has been reported by the routine histopathological examination.Conclusion: To detection sentine l lymph node, micrometastasis also allows for a more detailed path olo gical examination. It providesmakin g true node sta gin g in patients an d postoperative th erapy h e lps to or ganize appropriate support with non-small ce ll lun g cancer.

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