甲苯胺蓝-低分子右旋糖酐作为头颈部淋巴走行示踪剂的实验研究

Experimental study of toluidine blue-dextran-40 as lymphatic tracer in head and neck region

目的探讨甲苯胺蓝-低分子右旋糖酐(toluidine bule-dextran-40,TB-Dex-40)作为头颈部淋巴走行示踪剂的可行性及其应用价值。方法将20只健康成年新西兰大白兔按照简单随机的方法分为实验组(TB-Dex-40组)和对照组(TB组),每组10只,实验组行舌背近舌缘黏膜下注射1.0%(0.14 mOsm/L)的TB-Dex-40,对照组注射1.0%(32.60 mOsm/L)的TB,观察颈部淋巴管及淋巴结的染色时间和褪色时间,并测量两种染料在舌体扩散的范围。于染料着色后10 min、1 h和4周各摘取前哨淋巴结(sentinel lymph node,SLN)标本行组织病理学检查,在实验前及实验后4周对实验组动物进行血常规及血生化检查,之后处死所有动物取心、肺、肝、肾行病理学检查。结果实验组注射后经过(21.67±0.19)s到达SLN并使淋巴管着色,时间显著长于对照组[(3.22±0.34)s](P<0.01)。淋巴管从染色到完全褪色的时间:实验组[(19.70±1.34)min]显著长于对照组[(14.30±0.95)min](P<0.01)。实验组染色的SLN 4周后仍有明显着色,而对照组染色的SLN 2 d后已完全褪色。实验组染料在舌体扩散的范围[(10.50±1.08)mm]显著小于对照组[(20.00±1.05)mm](P<0.01)。实验组动物的各项血液指标及两组动物的主要脏器病理学检查均未见异常。结论TB-Dex-40对淋巴管具有较好的特异性,是一种良好的具有潜在临床应用价值的示踪剂。

Objective To investigate the feasibility and application value of toluidine bule-dextran-40(TB-Dex-40)as the tracer for lymphatic system in head and neck region.Methods Twenty healthy adult New Zealand white rabbits were equally divided into two groups:the experimental group(TB-Dex-40 group,n=10)and the control group(TB group,n=10).Rabbits in experimental group received submucosal injection of 1.0%(0.14 mOsm/L)TB-Dex-40,and the control group received injection of 1.0%(32.60 mOsm/L)TB.The staining time and fading time of lymphatic vessels and lymphnodes in the neck region were recorded,and the diffusion ranges of the two dyes in the tongue region were measured.Lymph nodespecimen were collected for pathological examination after 10 min,1 hour and 4 weeks of staining.The experimental animals were sacrificed before and 4 weeks after the experiment.After death,organs of heart,lung,liver and kidney were examined pathologically.Results TB-Dex-40 reached sentinel lymph node(SLN)and stained lymphatic vessels at an average of(21.67±0.19)s after injection,while in control group was(3.22±0.34)s(P<0.01).The time difference between the two dyes reaching sentinel lymph nodes was statistically significant.The durations from lymphatic staining to marked fading were(19.70±1.34)min in experimental group and(14.30±0.95)min in control group,respectively.The difference was statistically significant(P<0.01).SLN staining by TB-Dex-40 was still evident after 4 weeks,while TB staining has completely faded after 2 d.The average ranges of diffusionin tongue were(10.50±1.08)mm in experimental group and(20.00±1.05)mm in controlgroup,respectively.The difference was statistically significant(P<0.01).No abnormalities were found in blood test and pathological examination of main organs.Conclusions TB-Dex-40 has high specificity forstaining lymphatic vessels and is a good tracer with potential clinical value.