吲哚菁绿近红外光成像系统在非小细胞肺癌术中探寻前哨淋巴结的临床应用研究

Intraoperative detection of sentinel lymph nodes using indocyanine green fluorescence imaging system in non-small cell lung cancer

目的研究应用吲哚菁绿(ICG)近红外光成像系统术中探寻非小细胞肺癌(NSCLC)前哨淋巴结(SLN)的可行性及其判断区域淋巴结转移情况的准确性。方法 17例cⅠa^cⅡa期NSCLC患者,术中癌周围注射ICG 15 min后,行SLN检测,近红外光成像系统作用下发光淋巴结定义为SLN,并行肺叶切除及标准的系统性淋巴结清扫术,所有淋巴结送病理学检查。结果共14例患者成功识别SLN,SLN的识别率、假阴性率分别为82.4%和0,与染色法和核素法相比,有较高的识别率和较低的假阴性率。结论应用吲哚菁绿近红外光成像系统术中探寻早期NSCLC前哨淋巴结是一种安全可行的有效的判断区域淋巴结状态的方法。

Objective To determine the feasibility of detection of intraoperative sentinel lymph node （SLN） and the accuracy of judging of region lymph nodes metastasis by using indocyanine green fluorescence imaging system in patients with non-small cell lung cancer （NSCLC）. Methods Seventeen patients with clinical stage Ⅰa toⅡa, who finally underwent lung resection and systematic nodal dissection for NSCLC, were prospectively analyzed. ICG was injected in the peritumoral tissue and sentinel nodes were detected 15 minutes after injection by indocyanine green fluorescence imaging system. Histologic examination by hematoxylin-eosin staining was used to evaluate metastases. Results SLN was effectively performed on 14 patients. False negative rate and IR of the sentinel lymph node in predicting the status of lymph node stations were 82.4% and 0 respectively, which were higher than those of staining method and nuclide method. Conclusion It is a useful and feasible clinical procedure in predicting the status of lymph node stations in patients with NSCLC by indocyanine green fluorescence imaging system.