A Comparison of Indocyanine Green Fluorescence Imaging Plus Blue Dye and Blue Dye Alone for Sentinel Node Navigation Surgery in Breast Cancer Patients
A Comparison of Indocyanine Green Fluorescence Imaging Plus Blue Dye and Blue Dye Alone for Sentinel Node Navigation Surgery in Breast Cancer Patients
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DOI：
10.1245/s10434-012-2478-0
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发表时间：
2012-12-01
影响因子：
3.7
通讯作者：
Shimizu, Tadao
中科院分区：
文献类型：
--
作者：
Hirano, Akira;Kamimura, Mari;Shimizu, Tadao
评估两种使用蓝色染料联合或不联合吲哚菁绿（ICG）荧光成像（FI）的前哨淋巴结导航手术（SNNS）方法，以确定联合ICG和蓝色染料的有用性。 2005年至2010年，我院共有501名患者接受了SNNS。前哨淋巴结（SLN）的检测在2008年之前仅使用硫丹蓝（SB）进行，自2009年以来使用SB和ICG-FI组合进行。在乳晕下区域注射ICG 5 mg和SB 15 mg，并通过荧光成像设备获得FI。我们尝试在393名患者中单独使用SB以及在108名患者中使用SB和FI组合来识别SLN。单独使用 SB 方法检测到的 SLN 平均数量为 1.6 (0-5) 个，而组合方法检测到的 SLN 平均数量为 2.2 (1-6) 个。单独使用 SB 的 SLN 识别率为 95.7%，组合方法的 SLN 识别率为 100%，因此组合在识别率方面显着优于 SB（p = 0.0037）。在接受联合方法的患者中，1 名患者仅通过 SB 检测 SLN，8 名患者仅通过 ICG 检测，99 名患者均通过两种方法检测 SLN。单纯SB治疗56例，联合治疗16例，发现淋巴结转移。在 3 名仅使用 SB 的患者 (0.8%) 中观察到腋窝淋巴结复发，而使用联合方法的患者中没有观察到腋窝淋巴结复发。ICG-FI 是一种有用的方法，特别推荐在没有放射性示踪剂的情况下使用。
To evaluate two methods of sentinel node navigation surgery (SNNS) using blue dye with and without indocyanine green (ICG) fluorescence imaging (FI) to determine the usefulness of combined ICG and blue dye.Between 2005 and 2010, a total of 501 patients underwent SNNS in our hospital. Detection of sentinel lymph node (SLN) was performed with sulfan blue (SB) alone until 2008 and with a combination of SB and ICG-FI since 2009. ICG 5 mg and SB 15 mg were injected in the subareolar region, and FI was obtained by a fluorescence imaging device.We attempted to identify SLNs in 393 patients by SB alone and in 108 patients by a combination of SB and FI. The mean number of SLNs detected was 1.6 (0-5) for SB alone and 2.2 (1-6) for the combination method. The SLN identification rate was 95.7 % for SB alone and 100 % for the combination method so that the combination was significantly superior to SB in terms of the identification rate (p = 0.0037). In patients who received the combination method, detection of SLN was made through only SB in 1 patient, only ICG in 8 patients, and both in 99 patients. Lymph node metastasis was found in 56 patients with SB alone and in 16 patients with the combination method. Recurrence of an axillary node was observed in 3 patients (0.8 %) with SB alone and in no patients with the combination method.ICG-FI is a useful method and is especially recommended in cases where no radiotracers are available.