Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence
Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence
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DOI：
10.1002/bjs.6721
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发表时间：
2009-11-01
影响因子：
9.6
通讯作者：
Huenerbein, M.
中科院分区：
文献类型：
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作者：
Murawa, D.;Hirche, C.;Huenerbein, M.
背景：放射性同位素和蓝色染料的前哨淋巴结（SLN）活检已成功用于乳腺癌的腋窝分期。本研究评估了使用吲哚菁绿（ICG）荧光检测SLN用于淋巴绘图和SLN活检的可行性。
方法：30名乳腺癌女性在乳晕周围注射ICG，使用近红外摄像机进行SLN荧光检测。其中20人还接受了锝 - 99m标记的硫放射性胶体用于SLN闪烁显像。所有患者均接受腋窝淋巴结清扫术。两种方法的检出率和敏感性是研究的终点指标。
结果：通过荧光检测对淋巴管的可视化取决于ICG的剂量。ICG成像在30名女性中的29人识别出SLN（检出率为97%）。21名患者中有19人出现SLN转移（敏感性为90%），有2例假阴性结果。在同时使用两种方法的20名患者中，ICG荧光法和放射性胶体法分别在20名和17名患者中识别出SLN。在13名患者中分别有12名和10名患者被诊断出有转移性淋巴结（敏感性分别为92%和77%）。假阴性率分别为8%和23%。
结论：ICG荧光能够对淋巴管进行经皮成像和SLN检测，从而结合了放射性同位素和蓝色染料方法的优点。
Background: Sentinel lymph node (SLN) biopsy with radioisotope and blue dye has been used successfully for axillary staging in breast cancer. This study evaluated the feasibility of fluorescence detection of SLNs with indocyanine green (ICG) for lymphatic mapping and SLN biopsy.Methods: Thirty women with breast cancer had a periareolar injection of ICG for fluorescence detection of SLN using a near-infrared camera. Twenty also received Tc-99m-labelled sulphur radiocolloid for SLN scintigraphy. All patients underwent axillary lymph node dissection. Detection rate and Sensitivity of both methods were the study endpoints.Results: Visualization of lymphatic vessels by fluorescence detection depended oil the (lose of ICG. ICG imaging identified SLNs in 29 of 30 women (detection rate 97 per cent). Nineteen of 21 patients had metastatic SLN involvement (sensitivity 90 per cent) with false-negative results in two. Among the 20 patients who had both methods, ICG fluorescence and radiocolloid identified SLNs in 21) and 17 patients respectively. Metastatic lymph nodes were diagnosed in 12 and tell of 13 patients (sensitivity 92 and 77 per cent). False-negative rites were 8 and 23 per cent respectively.Conclusion: ICG fluorescence allowed transcutaneous imaging of lymphatic vessels and SLN detection, thus combining the advantages of radioisotope and blue dye methods.