Double sentinel lymph node mapping with indocyanine green and 99m-technetium-tin colloid in oral squamous cell carcinoma
Double sentinel lymph node mapping with indocyanine green and 99m-technetium-tin colloid in oral squamous cell carcinoma
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DOI：
10.1016/j.ijom.2015.05.008
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发表时间：
2015-10-01
影响因子：
2.4
通讯作者：
Hamakawa, H.
中科院分区：
文献类型：
--
作者：
Murase, R.;Tanaka, H.;Hamakawa, H.
口腔鳞状细胞癌(OSCC)常转移至颈部淋巴结，是最常见的预后因素。因此，识别前哨淋巴结(SLN)的筛查方法对于潜在颈部转移的治疗具有重要意义。本研究的目的是评价吲哚青绿(ICG)和99m-氚-锡胶(99m-TiN胶体)双标测SLN在前哨淋巴结导航手术(SNNS)中的临床价值。2007-2010年间，对16例确诊为口腔鳞癌的患者进行了SLN双重标测活检。术前一天在肿瘤周围注射99m-TiN胶体，术中同样位置注射ICG，辅助术中发现结节。根据ICG的伽马射线信号和近红外(NIR)荧光，识别SLN，然后从病理学和遗传学角度评估其与癌症的关系。所有患者的放射导向检测均获得成功。ICU标测发现了相对较多的结节，这表明可能涉及几个非SLN。双重标测方法辅助外科医生探查SLN。由于ICG荧光被皮下脂肪组织和包括颈阔肌和胸锁乳突肌在内的肌肉层屏蔽，因此有必要将组织从结节处收回。
Oral squamous cell carcinoma (OSCC) frequently metastasizes to cervical lymph nodes, which is the most known prognostic factor. Screening methods to identify sentinel lymph nodes (SLNs) are therefore of great interest for the management of potential neck metastasis. The purpose of this study was to evaluate the clinical benefit of double SLN mapping with indocyanine green (ICG) and 99m-technetium-tin colloid (Tc-99m-tin colloid) for sentinel node navigation surgery (SNNS). Between 2007 and 2010, 16 patients diagnosed with OSCC were investigated by SLN biopsy using the double mapping method. Tc-99m-tin colloid was injected into the peri-tumoural region on the preoperative day, and ICG was administered intraoperatively in the same position to assist in detecting nodes during surgery. Based on the gamma-ray signal and near-infrared (NIR) fluorescence of ICG, SLNs were identified and thereafter assessed pathologically and genetically for cancer involvement. Radio-guided detection was successful for all patients. ICU mapping identified a relatively larger number of nodes, suggesting that several non-SLNs were potentially involved. The double mapping method assisted surgeons to explore SLNs. Since the ICG fluorescence was shielded by the subcutaneous fatty tissue and the muscle layer including platysma and sternocleidomastoid, it was necessary to retract the tissue away from nodes.