Tagaya Nobumi, Yamazaki Rie, Nakagawa Aya, Abe Akihito, Hamada Kiyoshige, Kubota Keiichi, Oyama Tetsunari
Second Department of Surgery, Dokkyo University School of Medicine, Mibu, Tochigi, Japan.
Am J Surg. 2008 Jun;195(6):850-3. doi: 10.1016/j.amjsurg.2007.02.032. Epub 2008 Mar 26.
We present a novel method for sentinel lymph node (SLN) identification by fluorescence imaging that provides a high detection rate and a low false-negativity rate. Twenty-five breast cancer patients with tumors less than 3 cm in diameter were enrolled. A combination of indocyanine green and indigo carmine was injected subdermally in the areola. Subcutaneous lymphatic channels draining from the areola to the axilla were immediately showed by fluorescence imaging. After incising the axillary skin near the point of disappearance of the fluorescence, the SLN was dissected under fluorescence guidance. In all patients, the lymphatic channels and SLN were successfully visualized. The mean number of fluorescent SLN and blue-dyed SLN were 5.5 and 2.3. Eight patients were found to have lymph node metastases pathologically. All of them were recognized by fluorescence imaging. This method is feasible and safe for intraoperative detection of SLN allowing real-time observation without any need for training.
我们提出了一种通过荧光成像识别前哨淋巴结（SLN）的新方法，该方法具有高检测率和低假阴性率。纳入了25例直径小于3 cm肿瘤的乳腺癌患者。在乳晕皮下注射吲哚菁绿和靛胭脂的组合。通过荧光成像立即显示从乳晕引流至腋窝的皮下淋巴管。在荧光消失点附近切开腋窝皮肤后，在前哨淋巴结荧光引导下进行解剖。所有患者的淋巴管和前哨淋巴结均成功显影。荧光前哨淋巴结和蓝色染料标记前哨淋巴结的平均数量分别为5.5个和2.3个。病理检查发现8例患者有淋巴结转移。所有这些均通过荧光成像识别。该方法对于术中检测前哨淋巴结是可行且安全的，无需任何培训即可进行实时观察。
