Development of sentinel lymph node identification using a new tracer of fluorescsnt beads for gastrointestinal carcinoma

使用新型荧光珠示踪剂进行胃肠癌前哨淋巴结识别的进展

• 批准号: 16591375
• 负责人: HIRAI Toshihiro
• 金额: $ 0.83万
• 依托单位: Kawasaki Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2004
• 资助国家: 日本
• 起止时间: 2004 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-16591375/
• 关键词: sentinel lymph node; fluorescent beads; gastric carcinoma; 微小転移

This study examined that availability of FBM for detecting of sentinel lymph node(SN) for patients with GC. Kawasaki Medical College Institutional Review Board approved the fluorescent beads methods(FBM) for the cases of gastric carcinoma(GC) under the patient's consent.On the day before surgery, 1ml of fluorescent beads(FB) was injected by an endoscope to four points of submucosal layer around the lesion. Ultraviolet (UV) irradiation was performed during the operation, and extracted lymph nodes were irradiated to detect SN. Light-emitting lymph nodes(LN) were assumed to be SN. At the same time, SN was detected by dye (ICG) methods injected into the subserosal layear from the serosal side surrounding a lesion at the operation time. During 15 minutes after the injection of ICG, green nodes could beb assumed to be SN. After the sampling of SN, a lymphadenectomy was done for compartments I and II. SN detection was performed for 24 patients with early GC. The SN detection rate was 75% (18/24 cases) in FBM. The average number of SN was 2.3. The SN detection rate using FB combined with ICG methods was 91.6%. The SN detection rate of FB alone was low. The FBM should be combined with ICG methods at the same time. Moreover, it was difficult to detect a fluorescent LN hidden in the adipose tissue during surgery because of autofluorescence of the adipose tissue. However, it was able to detected SN by UV irradiation to excision extraction tissue. For the purpose of application FB to clinical use in the future, a new UV irradiation instrumental should be devised to detect SN during the operation.

本研究探讨了 FBM 用于检测 GC 患者前哨淋巴结 (SN) 的可用性。川崎医学院机构审查委员会在患者同意的情况下批准了荧光珠法（FBM）用于胃癌（GC）病例。手术前一天，通过内窥镜将1ml荧光珠（FB）注射到病灶周围粘膜下层的四个点。术中进行紫外线（UV）照射，并对提取的淋巴结进行照射检测SN。假设发光淋巴结（LN）为 SN。同时，通过手术时从病灶周围浆膜侧注入浆膜下层的染料（ICG）方法检测SN。注射 ICG 后 15 分钟内，绿色节点可被假定为 SN。 SN 取样后，对 I 区和 II 区进行淋巴结切除术。对24例早期GC患者进行SN检测。 FBM 中 SN 检出率为 75%（18/24 例）。 SN的平均数为2.3。 FB结合ICG方法的SN检出率为91.6%。单独FB的SN检出率较低。 FBM应与ICG方法同时结合。此外，由于脂肪组织的自发荧光，在手术过程中很难检测到隐藏在脂肪组织中的荧光LN。然而，通过对切除提取组织进行紫外线照射，能够检测到SN。为了将来FB应用于临床，应设计一种新的紫外照射仪器来检测手术过程中的SN。