吲哚菁绿分子荧光影像技术在乳腺癌单孔法腔镜前哨淋巴结活检术中的应用

The application of indocyanine green molecular fluorescence imaging technology in single port laparoscopic sentinel lymph node biopsy in breast cancer

目的:探讨吲哚菁绿(ICG)分子荧光影像技术在单孔法腔镜前哨淋巴结活检术中的应用价值。方法:选取2019年3月至2019年12月收治的行腔镜前哨淋巴结活检术的20例早期乳腺癌患者,均以ICG联合纳米碳混悬注射液作为示踪剂。手术切除的前哨淋巴结送术中冰冻病理检查及常规石蜡病理检查。比较前哨淋巴结检出率、前哨淋巴结转移数量及ICG单独显影、纳米碳单独显影、ICG+纳米碳同时显影的前哨淋巴结数量。结果:ICG、纳米碳、ICG+纳米碳前哨淋巴结检出率分别为100.0%、95.0%、100%;前哨淋巴结检出数量分别为89枚、77枚、97枚,前哨淋巴结检出数量平均为(4.45±1.86)枚、(3.85±1.98)枚、(4.85±2.22)枚,ICG组与纳米碳组差异有统计学意义(P<0.05),ICG+纳米碳组与纳米碳组之间差异亦有统计学意义(P<0.001)。20例患者中3例检出前哨淋巴结转移,转移前哨淋巴结7枚;7枚转移前哨淋巴结均被ICG检出,纳米碳仅检出其中2例患者共5枚转移前哨淋巴结。结论:ICG与单孔法腔镜前哨淋巴结活检术结合应用,具有较高的前哨淋巴结检出率及淋巴结检出数量,且前哨淋巴结假阴性率可能较低。

Objective:To investigate the application value of indocyanine green(ICG)molecular fluorescence imaging technology in single port laparoscopic sentinel lymph node biopsy for breast cancer.Methods:A total of 20 patients who underwent single-port laparoscopic sentinel node biopsy from Mar.2019 to Dec.2019 were enrolled and all the procedures were performed by injection of both ICG and carbon nanoparticles.Intraoperative frozen section was performed and followed by conventional histopathology.The detection rate of sentinel lymph node,positive sentinel lymph node,the number of sentinel lymph node developed by ICG,nanocarbon,and ICG+nanocarbon were compared.Results:The detection rates of sentinel lymph nodes of ICG,nanocarbon,and ICG+nanocarbon were 100.0%,95.0%,and 100%,respectively;the number of sentinel lymph nodes detected were 89,77 and 97,respectively;the average number of sentinel lymph nodes detected was(4.45±1.86),(3.85±1.98),(4.85±2.22),respectively.There was statistical difference between ICG and nanocarbon group(P<0.05).There was also significant difference between ICG+nanocarbon group and nanocarbon group(P<0.001).In 20 patients,a total of 3 patients with positive sentinel lymph nodes were detected.Seven positive sentinel lymph nodes were detected by ICG.Nanocarbon only detected 5 positive sentinel lymph nodes in 2 patients.Conclusions:The combined application of ICG and single-port endoscopic sentinel lymph node biopsy has a higher detection rate and more sentinel lymph nodes detected,and may bring a lower false-negative rate of sentinel lymph nodes.