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

Abstract

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

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-.

References

［1］ Flach GB, Bloemena E, Klop WM, et al. Sentinel lymph node biopsy in clinically N0 T1T2 staged oral cancer: the Dutch multicenter trial［J］. Oral Oncol, 2014, 50(10): 10201024. DOI:10.1016/j.oraloncology.2014.07.020. ［2］ Thompson CF, St John MA, Lawson G, et al. Diagnostic value of sentinel lymph node biopsy in head and neck cancer: a metaanalysis［J］. Eur Arch Otorhinolaryngol, 2013, 270(7): 21152122. DOI:10.1007/s0040501223200. ［3］李思毅, 吴开柳, 陆伟, 等. 早期口腔癌颈部淋巴结处理［J］. 实用肿瘤杂志, 2015, 30(1): 811. ［4］ Tanis PJ, Nieweg OE, Van Den Brekel MW, et al. Dilemma of clinically nodenegative head and neck melanoma: outcome of "watch and wait" policy, elective lymph node dissection, and sentinel node biopsy—a systematic review［J］. Head Neck, 2008, 30(3): 380389. DOI:10.1002/hed.20749. ［5］郭朱明, 王顺兰, 曾宗渊, 等. 舌体鳞癌隐匿性颈淋巴结转移的外科治疗探讨［J］. 癌症, 2005, 24(3): 368370. ［6］ Stoeckli SJ, Pfaltz M, Ross GL, et al. The second international conference on sentinel node biopsy in mucosal head and neck cancer［J］. Ann Surg Oncol, 2005, 12(11): 919924. DOI:10.1245/ASO.2005.11.024. ［7］ Alkureishi LW, Burak Z, Alvarez JA, et al. Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma［J］. Eur J Nucl Med Mol Imaging, 2009, 36(11): 19151936. DOI:10.1007/s0025900912480. ［8］彭汉伟, 曾宗渊, 陈福进, 等. 舌癌前哨淋巴结活检的临床研究［J］. 中华口腔医学杂志, 2004, 39(2): 126128. ［9］彭汉伟, 曾宗渊, 陈福进, 等. cN0舌癌前哨淋巴结定位方法研究［J］. 癌症, 2003, 22(3): 286290. ［10］ Kitai T, Inomoto T, Miwa M, et al. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer［J］. Breast Cancer, 2005, 12(3): 211215. ［11］ Zelken JA, Tufaro AP. Current trends and emerging future of indocyanine green usage in surgery and oncology: an update［J］. Ann Surg Oncol, 2015, In press. DOI:10.1245/s1043401547435. ［12］ Alvarez Amézaga J, Barbier Herrero L, Pijoan Del Barrio JI, et al. Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma. Cohort study and metaanalysis［J］. Med Oral Patol Oral Cir Bucal, 2007, 12(3): E235E243. ［13］ Hayashi T, Furukawa H, Oyama A, et al. Sentinel lymph node biopsy using realtime fluorescence navigation with indocyanine green in cutaneous head and neck/lip mucosa melanomas［J］. Head Neck, 2012, 34(5): 758761. DOI:10.1002/hed.21651. ［14］ Iwai T, Maegawa J, Hirota M, et al. Sentinel lymph node biopsy using a new indocyanine green fluorescence imaging system with a colour charged couple device camera for oral cancer［J］. Br J Oral Maxillofac Surg, 2013, 51(2): e26e28. DOI:10.1016/j.bjoms.2012.03.002. ［15］ Nakamura T, Kogashiwa Y, Nagafuji H, et al. Validity of sentinel lymph node biopsy by ICG fluorescence for early head and neck cancer［J］. Anticancer Res, 2015, 35(3): 16691674. ［16］ Van Der Vorst JR, Schaafsma BE, Verbeek FP, et al. Nearinfrared fluorescence sentinel lymph node mapping of the oral cavity in head and neck cancer patients［J］. Oral Oncol, 2013, 49(1): 1519. ［17］ Van Den Berg NS, Brouwer OR, Klop WM, et al. Concomitant radio and fluorescenceguided sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity using ICG(99m)Tcnanocolloid［J］. Eur J Nucl Med Mol Imaging, 2012, 39(7): 11281136. DOI:10.1007/s0025901221295. ［18］ Bredell MG. Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer preliminary experience［J］. Head Neck Oncol, 2010, 2: 31. DOI:10.1186/17583284231.

[1]	Fan Mengsi, Lu Yaping, Yan Li. Analysis of clinicopathologic features of false negative sentinel lymph nodes in patients with endometrial cancer [J]. Journal of International Oncology, 2023, 50(5): 274-279.
[2]	Shi Yu, Chen Xi, Xu Mengqi, Zhang Yingying, Ji Honghai, Jiang Yingying. Effects of PSIP1 gene silencing on migration and invasion of oral squamous cell carcinoma cells [J]. Journal of International Oncology, 2022, 49(3): 129-133.
[3]	Yang Fan, Guan Xiaoyan, Liu Jianguo, Xiao Linlin, Yue Chaoyi, Long Qian, Liao Chengcheng. Research progress of FOXO1 in oral squamous cell carcinoma [J]. Journal of International Oncology, 2022, 49(10): 612-614.
[4]	Zhou Changqun, Guan Xiaoyan, Liu Jianguo, Yue Chaoyi, Liao Chengcheng. Research progress on the malignant transformation of oral submucosal fibrosis [J]. Journal of International Oncology, 2022, 49(10): 608-611.
[5]	Shi Manman, Chen Chuang, Li Zhiyu, Sun Shengrong. Tracers′ clinical application status in the sentinel lymph node biopsy of breast cancer [J]. Journal of International Oncology, 2018, 45(4): 245-249.