近红外线吲哚氰绿荧光显像法在cN0口腔癌前哨淋巴结活检中的应用

摘要/Abstract

摘要： 摘要】目的评价近红外线吲哚氰绿（ICG）荧光显像法在临床淋巴结阴性（cN0）口腔癌术中前哨淋巴结活检中的可行性和有效性。方法符合条件且知情同意的cT13N0M0口腔（或口咽）癌患者30例入组。切开皮肤前用1 ml注射器抽取ICG（25 mg/5 ml）1 ml行瘤周四象限和基底注射；随后行常规颈清扫切口翻瓣游离胸锁乳突肌并将其向后牵拉，显露术野，用近红外线荧光成像系统扫描术区直至捕获荧光热点，切除热点淋巴结；离体淋巴结经再次扫描确认为荧光热点者定义为前哨淋巴结。完成颈清扫后将前哨淋巴结和非前哨淋巴结分别送病理检查。结果全组30例均成功地获取前哨淋巴结，每例前哨淋巴结数目1～9枚，平均3.4枚。常规病理证实30例中5例（16.67%）有隐匿性转移，转移淋巴结全部为前哨淋巴结。全组未发生ICG相关的不良反应。结论近红外线ICG荧光显像法对cN0口腔癌行术中前哨淋巴结活检成功率高，前哨淋巴结能准确评价颈淋巴结转移状况。该方法简单可行，有发展前景，值得进一步研究。

关键词: 口腔肿瘤, 前哨淋巴结活组织检查, 谱学, 近红外线, 光谱法, 荧光, 吲哚氰绿

Abstract: 【Abstract】ObjectiveTo evaluate the feasibility and validity of near infrared fluorescence imaging with indocyanine green in sentinel node biopsy for cN0 oral carcinoma. MethodsThirty cases of previously untreated oral carcinoma staged cT13N0M0 were enrolled in this study. 1 ml of indocyanine green (25 mg/5 ml) was injected both around the primary tumor in a 4 quadrant pattern and in the base of the tumor before skin incision. After elevation of the platysma flap and posterior retraction of the sternocleidomastoid muscle, fluorescence images were taken with a near infrared fluorescence detector until the hotspots were captured, then the hotspot lymph nodes were removed. Lymph nodes identified with fluorescent hotspots and verified in vivo were defined as sentinel nodes, and they were harvested and sent together with neck dissection specimen for pathologic study. ResultsSentinel nodes were successfully harvested in all 30 cases. The number of sentinel nodes per case varied from 1 to 9, with an average number of 3.4. Routine pathology demonstrated that occult metastasis was exclusively found in the sentinel nodes in 5 cases (16.67%), and all the other lymph nodes were free from metastasis. No tracer associated adverse effects occurred in this series. ConclusionNear infrared fluorescence imaging with indocyanine green has a high detection rate in sentinel node biopsy for cN0 oral/oropharyngeal carcinoma and the sentinel nodes can evaluate the cervical metastatic status accurately. It is an easy, feasible and promising method, which is worthy of further investigation.

Key words: Oral neoplasms, Sentinel lymph node biopsy, Spectroscopy, nearinfrared, Spectrometry, fluorescence, Indocyanine green

林建英, 杨熙鸿, 郭海鹏, 徐漫彬, 许少伟, 彭汉伟. 近红外线吲哚氰绿荧光显像法在cN₀口腔癌前哨淋巴结活检中的应用[J]. 国际肿瘤学杂志, 2016, 43(2): 86-.

LIN Jian-Ying, YANG Xi-Hong, GUO Hai-Peng, XU Man-Bin, XU Shao-Wei, PENG Han-Wei. Application of near infrared fluorescence imaging with indocyanine green in sentinel node biopsy for cN0 oral carcinoma[J]. Journal of International Oncology, 2016, 43(2): 86-.

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近红外线吲哚氰绿荧光显像法在cN₀口腔癌前哨淋巴结活检中的应用

Application of near infrared fluorescence imaging with indocyanine green in sentinel node biopsy for cN0 oral carcinoma

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