优化近红外荧光示踪法在宫颈癌前哨淋巴结定位中的应用。
Optimization of near-infrared fluorescent sentinel lymph node mapping for vulvar cancer.
机构信息
Department of Surgery, Leiden University Medical Center, the Netherlands.
出版信息
Am J Obstet Gynecol. 2012 Jan;206(1):89.e1-5. doi: 10.1016/j.ajog.2011.07.039. Epub 2011 Jul 30.
Abstract
OBJECTIVES
Near-infrared fluorescence imaging has the potential to improve sentinel lymph node mapping in vulvar cancer, which was assessed in the current study. Furthermore, dose optimization of indocyanine green adsorbed to human serum albumin was performed.
STUDY DESIGN
Nine vulvar cancer patients underwent the standard sentinel lymph node procedure using (99m)technetium-nancolloid and patent blue. In addition, intraoperative imaging was performed after peritumoral injection of 1.6 mL of 500, 750, or 1000 μM of indocyanine green adsorbed to human serum albumin.
RESULTS
Near-infrared fluorescence sentinel lymph node mapping was successful in all patients. A total of 14 sentinel lymph nodes (average, 1.6; range, 1-4) were detected: 14 radioactive (100%), 11 blue (79%), and 14 near-infrared fluorescent (100%).
CONCLUSION
This study demonstrates feasibility and accuracy of sentinel lymph node mapping using indocyanine green adsorbed to human serum albumin. Considering safety, cost, and pharmacy preferences, an indocyanine green adsorbed to human serum albumin concentration of 500 μM appears optimal for sentinel lymph node mapping in vulvar cancer.
摘要
目的
近红外荧光成像有可能改善外阴癌前哨淋巴结的定位，本研究对此进行了评估。此外，还对人血清白蛋白结合的吲哚菁绿进行了剂量优化。
研究设计
9 名外阴癌患者接受了（99m）锝-纳米胶体和专利蓝的标准前哨淋巴结程序。此外，在肿瘤周围注射 1.6 mL 500、750 或 1000 μM 人血清白蛋白结合的吲哚菁绿后，进行术中成像。
结果
所有患者的近红外荧光前哨淋巴结定位均成功。共检测到 14 个前哨淋巴结（平均 1.6；范围 1-4）：放射性 14 个（100%）、蓝色 11 个（79%）和近红外荧光 14 个（100%）。
结论
本研究证明了使用人血清白蛋白结合的吲哚菁绿进行前哨淋巴结定位的可行性和准确性。考虑到安全性、成本和药房偏好，人血清白蛋白结合的吲哚菁绿浓度为 500 μM 似乎对外阴癌前哨淋巴结定位最理想。
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