Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, USA.
Gynecol Oncol. 2012 Jan;124(1):78-82. doi: 10.1016/j.ygyno.2011.09.025. Epub 2011 Oct 11.
Traditional techniques of sentinel lymph node (SLN) mapping for endometrial and cervical cancer present challenges which may be overcome with newer technologies such as near infrared (NIR) imaging of the fluorescent dye Indocyanine green (ICG). We performed a feasibility and dose-finding study to define the dose of ICG required to identify pelvic and para-aortic sentinel lymph nodes with robotically assisted endoscopic NIR imaging after cervical injection.
20 subjects with cervical or endometrial carcinoma were prospectively enrolled for SLN mapping. ICG was injected into the cervical stroma at 3 o'clock and 9 o'clock Data was collected for the number of nodes identified, the location of SLN's, the duration of procedure and the pathology characteristics of the SLN's compared to the non-sentinel lymph nodes.
20 subjects received cervical injection with at least one SLN observed in 17 subjects. 15 of the 17 subjects who received 1mg injections of ICG mapped a SLN for an observed detection rate of 88% (95% CI is (64%,99%)). A median of 4.5 SLN's was identified per patient. Three patients had lymphatic metastases, one of whom had a positive SLN. No adverse events were identified.
A 1mg cervical injection of ICG identified a SLN in 88% of patients (95% CI is (64%, 99%)). Robotically assisted fluorescence imaging is a feasible, safe, time efficient and reliable method for lymphatic mapping in early stage cervical and endometrial cancer.
传统的子宫内膜癌和宫颈癌前哨淋巴结（SLN）示踪技术存在一定挑战，而近红外（NIR）成像技术如吲哚菁绿（ICG）荧光染料可能克服这些挑战。我们进行了一项可行性和剂量探索研究，以确定经宫颈注射后，机器人辅助内镜 NIR 成像识别盆腔和腹主动脉旁 SLN 所需的 ICG 剂量。
前瞻性纳入 20 例宫颈癌或子宫内膜癌患者进行 SLN 检测。在宫颈间质 3 点和 9 点注射 ICG。收集识别的淋巴结数量、SLN 位置、手术持续时间以及与非前哨淋巴结相比的 SLN 病理学特征等数据。
17 例患者中至少有 1 例观察到 SLN，17 例患者中有 15 例接受了 1mg ICG 注射，观察到的检出率为 88%（95%CI 为（64%，99%））。每位患者平均识别出 4.5 个 SLN。3 例患者存在淋巴转移，其中 1 例 SLN 阳性。未发现不良事件。
1mg 经宫颈注射 ICG 可在 88%的患者中识别出 SLN（95%CI 为（64%，99%））。机器人辅助荧光成像技术是一种可行、安全、高效、可靠的早期宫颈癌和子宫内膜癌淋巴示踪方法。
