自发荧光物质在前哨淋巴结活检中的应用

Sentinel Lymph Node Mapping Using Near-infrared Fluorescence

目的:前哨淋巴结活检代替腋窝清扫术已经日益成为临床工作中的标准术式。选择合适的示踪剂准确定位前哨淋巴结能够提高手术成功率、缩短学习曲线,更利于在基层医院推广。本研究探讨了自发荧光物质在前哨淋巴结活检中的应用前景。方法:使用荧光光谱仪测定美蓝溶液最佳激发光谱和发射光谱;将美蓝注射到白兔乳房皮下,通过小动物活体成像系统观察美蓝在体内向腋窝淋巴结引流并且聚集在腋窝淋巴结区域的过程。解剖腋窝区域寻找蓝染前哨淋巴结并观察其发光情况。结果:美蓝具有自发荧光的性质,其发出的近红外荧光可以在体外对腋淋巴引流及前哨淋巴结起到定位作用。结论:提示近红外荧光自发荧光物质作为前哨淋巴结示踪剂具有一定的应用前景。

Objective： The sentinel lymph node （ SLN ） biopsy has become a standard surgical procedure for staging the breast cancer, instead of axillary lymph node dissection （ ALD ）. Using an appropriate tracer can increase the success rate and shorten the learning curve, so that the SLN procedure can be made accessible in primary hospitals. This study aims to discuss a novel method for sentinel lymph node （ SLN ） identification by fluorescent imaging. Methods： The optimal excitation and emission spectrum of MB solution were determined using a fluorescence spectrometer. The MB solution was subcutaneously injected to the breast of rabbit. A fluo- rescence spectrum in vivo imaging system of small animals was used to observe the lymphatic drainage and axillary SLN uptake of MB. The blue-stained SLNs were searched in the armpit, and fluorescence property was observed. Results： MB has a property of au- to-fluorescence. The near-infrared （ NIR ） fluorescence of MB played a role for labeling the in vivo axillary lymph node drainage and mapping SLN. Conclusion： NIR fluorescence reagent may be a better tracer in mapping SLN for its visibility in vivo and in vivo.