Kinami Shinichi, Oonishi Toshio, Fujita Jun, Tomita Yasuto, Funaki Hiroshi, Fujita Hideto, Nakano Yasuharu, Ueda Nobuhiko, Kosaka Takeo
Department of Surgical Oncology, Kanazawa Medical University Hospital, Ishikawa 920-0293, Japan.
Oncol Lett. 2016 Jun;11(6):4055-4062. doi: 10.3892/ol.2016.4492. Epub 2016 Apr 25.
Indocyanine green (ICG) fluorescence imaging represents a promising method for sentinel node (SN) biopsy in laparoscopic gastric surgery due to its signal stability. In the present study, the suitability and optimal settings of ICG fluorescence imaging for SN biopsy in early gastric cancer were determined. Patients with single primary superficial-type adenocarcinoma of the stomach, lesions <5 cm in diameter, and no evident nodal metastasis and out of indication for endoscopic submucosal dissection were enrolled. The day prior to surgery, ICG solution was endoscopically injected into four quadrants of the submucosal layer of the tumor. The Photodynamic Eye was used to detect ICG fluorescence. Bright nodes were defined as clearly fluorescent nodes. A total of 72 patients were enrolled; 11 cases presented with metastasis, and of these, 10 could be diagnosed by bright node biopsy. The adequate concentration and injection volume of ICG was determined to be 50 µg/ml (×100) and 0.5 mlx4 points, respectively. There was 1 false-negative case, and this was attributed to the failure of the frozen section diagnosis. These results suggested that ICG fluorescence imaging for SN biopsy in laparoscopic surgery for early gastric cancer is feasible. However, a weakness of ICG fluorescence imaging is the subjectivity of bright node evaluation.
吲哚菁绿（ICG）荧光成像因其信号稳定性，是腹腔镜胃癌手术中前哨淋巴结（SN）活检的一种有前景的方法。在本研究中，确定了ICG荧光成像用于早期胃癌SN活检的适用性和最佳设置。纳入了患有单一原发性胃浅表型腺癌、直径<5 cm的病变、无明显淋巴结转移且不符合内镜黏膜下剥离指征的患者。手术前一天，通过内镜将ICG溶液注入肿瘤黏膜下层的四个象限。使用光动力眼检测ICG荧光。明亮淋巴结定义为荧光清晰的淋巴结。共纳入72例患者；11例出现转移，其中10例可通过明亮淋巴结活检诊断。确定ICG的合适浓度和注射量分别为50 μg/ml（×100）和0.5 ml×4点。有1例假阴性病例，这归因于冰冻切片诊断失败。这些结果表明，ICG荧光成像用于早期胃癌腹腔镜手术中的SN活检是可行的。然而，ICG荧光成像的一个缺点是明亮淋巴结评估的主观性。
