Near-infrared fluorescence sentinel lymph node mapping in breast cancer: a multicenter experience.
Near-infrared fluorescence sentinel lymph node mapping in breast cancer: a multicenter experience.
复制标题
乳腺癌中的近红外荧光前哨淋巴结映射：多中心体验。
DOI：
10.1007/s10549-013-2802-9
复制
发表时间：
2014-01
影响因子：
3.8
通讯作者：
Frangioni, John V.
中科院分区：
文献类型：
--
作者：
Verbeek, Floris P. R.;Troyan, Susan L.;Mieog, J. Sven D.;Liefers, Gerrit-Jan;Moffitt, Lorissa A.;Rosenberg, Mireille;Hirshfield-Bartek, Judith;Gioux, Sylvain;van de Velde, Cornelis J. H.;Vahrmeijer, Alexander L.;Frangioni, John V.
使用吲哚菁绿（ICG）的近红外荧光成像有可能通过促进经皮和术中淋巴通道和SLN的识别来改进SLN手术。先前的研究表明，0.62 mg (1.6 ml 0.5 mM) ICG的剂量是乳腺癌SLN定位的最佳剂量。本研究的目的是评估近红外（NIR）荧光在与传统技术结合使用时对乳腺癌前哨淋巴结（SLN）定位的诊断准确性。研究对象为2010年7月至2013年1月期间计划在丹娜-法伯/哈佛癌症中心（波士顿，马萨诸塞州，美国）或莱顿大学医学中心（莱顿，荷兰）接受SLN手术的95名乳腺癌患者。受试者在每个机构接受标准护理SLN程序，所有受试者使用99technetium -胶体，27名（28%）受试者使用专利蓝。使用Mini-FLARE成像系统进行近红外荧光引导SLN检测。使用近红外荧光成像或近红外荧光成像与放射性引导的结合，95名受试者中有94名（99%）成功识别SLN。在95名受试者中，有2人需要放射性指导才能初步在体内识别sln。在95名受试者中，有1人需要近红外荧光对sln进行初步体内鉴定。共切除177个sln（平均值= 1.9，范围= 1-5）：100%近红外荧光，88%放射性，78%（40个淋巴结）蓝色。95例患者中有2例（2.1%）仅通过近红外荧光发现含有大转移灶的sln，其中1例患者的转移期上升至N1。本研究证明了近红外荧光成像在乳腺癌患者中识别sln的安全性和准确性，但在未来的研究中应该使用什么技术作为金标准，这是一个问题。
NIR fluorescence imaging using indocyanine green (ICG) has the potential to improve the SLN procedure by facilitating percutaneous and intraoperative identification of lymphatic channels and SLNs. Previous studies suggested that a dose of 0.62 mg (1.6 ml of 0.5 mM) ICG is optimal for SLN mapping in breast cancer. The aim of this study was to evaluate the diagnostic accuracy of near-infrared (NIR) fluorescence for sentinel lymph node (SLN) mapping in breast cancer patients when used in conjunction with conventional techniques. Study subjects were 95 breast cancer patients planning to undergo SLN procedure at either the Dana-Farber/Harvard Cancer Center (Boston, MA, USA) or the Leiden University Medical Center (Leiden, the Netherlands) between July 2010 and January 2013. Subjects underwent the standard-of-care SLN procedure at each institution using 99Technetium-colloid in all subjects and patent blue in 27 (28%) of the subjects. NIR fluorescence-guided SLN detection was performed using the Mini-FLARE imaging system. SLN identification was successful in 94 of 95 subjects (99%) using NIR fluorescence imaging or a combination of both NIR fluorescence imaging and radioactive guidance. In 2 of 95 subjects, radioactive guidance was necessary for initial in vivo identification of SLNs. In 1 of 95 subjects, NIR fluorescence was necessary for initial in vivo identification of SLNs. A total of 177 SLNs (mean = 1.9, range = 1–5) were resected: 100% NIR fluorescent, 88% radioactive, and 78% (of 40 nodes) blue. In 2 of 95 subjects (2.1%), SLNs containing macrometastases were found only by NIR fluorescence, and in 1 patient this led to upstaging to N1. This study demonstrates the safe and accurate application of NIR fluorescence imaging for the identification of SLNs in breast cancer patients, but calls into question what technique should be used as the gold standard in future studies.
登录
查看更多内容
影响因子：
9
作者：
Cox, CE;Pendas, S;Reintgen, DS
通讯作者：
Reintgen, DS
影响因子：
3.8
作者：
Goyal, Amit;Newcombe, Robert G.;Mansel, Robert E.
通讯作者：
Mansel, Robert E.
影响因子：
3.7
作者：
Hirano, Akira;Kamimura, Mari;Shimizu, Tadao
通讯作者：
Shimizu, Tadao
影响因子：
3.9
作者：
Hojo, Takashi;Nagao, Tomoya;Kinoshita, Takayuki
通讯作者：
Kinoshita, Takayuki
影响因子：
2.6
作者：
Pesek, Sarah;Ashikaga, Taka;Krag, Lars Erik;Krag, David
通讯作者：
Krag, David