Detection of pleural lymph flow using indocyanine green fluorescence imaging in non-small cell lung cancer surgery: a preliminary study
Detection of pleural lymph flow using indocyanine green fluorescence imaging in non-small cell lung cancer surgery: a preliminary study
复制标题
DOI：
10.1007/s00595-012-0237-2
复制
发表时间：
2013-03-01
期刊：
影响因子：
2.5
通讯作者：
Ogawa, Jun-ichi
中科院分区：
文献类型：
--
作者：
Imai, Kazuhiro;Minamiya, Yoshihiro;Ogawa, Jun-ichi
肺癌淋巴结转移至纵隔是决定预后的关键因素。淋巴流经常携带转移瘤从肺段直接进入纵隔淋巴结，而不通过肺门淋巴结。这种现象被称为“跳跃转移”。“本研究使用吲哚菁绿色（ICG）和近红外荧光成像系统研究了胸膜下淋巴流向纵隔的情况。将含有荧光染料ICG（5 mg/ml）的0.3ml溶液样品注射到原发性肿瘤附近的胸膜下部位。应用荧光成像技术监测注射部位含ICG淋巴液的流动5 min，评价原发肿瘤的解剖节段与淋巴液流动的关系，14例患者（82.4%）的ICG荧光显示了注射部位引流的淋巴管。14例中有3例（21.4%）淋巴液直接流入纵隔，证实了术中淋巴液直接流入纵隔而不经肺门。这些初步结果为进一步研究跳跃转移的机制提供了有价值的线索。
Lymphatic spread of lung carcinoma to the mediastinum is a key determinant of prognosis. The lymph flow often carries metastases from the pulmonary segment directly into the mediastinal lymph nodes, without passing through the hilar nodes. This phenomenon is termed as "skip metastasis." This study investigated the subpleural lymphatic flow to the mediastinum using indocyanine green (ICG) with a near-infrared fluorescence imaging system.Seventeen patients with lung cancer were enrolled in this study. A 0.3 ml sample of solution containing the fluorescent dye ICG (5 mg/ml) was injected into subpleural sites near the primary tumor. Fluorescence imaging was used to monitor the flow of ICG-containing lymph from the injection site for 5 min. The relationship between the anatomical segment of the primary tumor and the lymphatic flow was assessed.The lymphatic vessels draining from the injection site were revealed by the bright ICG fluorescence in 14 of the patients (82.4 %). A direct lymphatic flow to the mediastinum was confirmed in 3 of those 14 (21.4 %).These findings confirm the direct flow of lymph to the mediastinum without passage through the hilum pulmonis intraoperatively. These preliminary results may provide a valuable clue for further investigations of the mechanisms underlying skip metastasis.