Guenane Y, Gorj M, Nguyen V, Revol M, Mazouz-Dorval S
Service de chirurgie plastique, reconstructrice et esthétique, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Service de chirurgie plastique, reconstructrice et esthétique, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Ann Chir Plast Esthet. 2016 Dec;61(6):806-810. doi: 10.1016/j.anplas.2016.05.004. Epub 2016 Jun 16.
Axillary sentinel lymph node (SN) biopsy by using indocyanine green (ICG) fluorescence for breast cancer is a recent technique. However, compared to Technetium-99m (Tc), which is the reference technique, its efficiency has received little testing.
Between December 2013 and January 2014, 40 patients with node-negative breast cancer underwent SN biopsy by injecting sub areolar Tc in preoperative stage and injecting sub areolar ICG in intraoperative stage. SN were previously identified and resected by using ICG coupled with infrared camera. After resection of fluorescent SN, we check its radioactivity with a gamma probe (isotopic method). In case of residual radioactive labeling in the axillary crease, we remove the remaining SN. We have retrospectively analyzed the SN detection concordance rates of these two methods.
In total we resected 53 SN, among which 48 (90.6%) were indocyanine green positive and 53 (100%) Tc positive. The remaining 5 SN were all ICG negative and Tc positive. Using ICG has not caused any side effect.
SN detection for breast cancer by using ICG fluorescence is a promising, reliable technique which nonetheless requires a degree of expertise before reaching similar results as the Tc technique.
通过吲哚菁绿（ICG）荧光进行乳腺癌腋窝前哨淋巴结（SN）活检是一项新技术。然而，与作为参考技术的锝-99m（Tc）相比，其效率尚未得到充分测试。
2013年12月至2014年1月期间，40例淋巴结阴性乳腺癌患者在术前经乳晕下注射Tc，术中经乳晕下注射ICG后接受SN活检。SN先前通过ICG结合红外摄像机进行识别和切除。切除荧光SN后，我们用γ探测仪检查其放射性（同位素法）。如果腋窝皱襞处有残留放射性标记，我们将切除剩余的SN。我们回顾性分析了这两种方法的SN检测符合率。
我们总共切除了53个SN，其中48个（90.6%）吲哚菁绿阳性，53个（100%）Tc阳性。其余5个SN均为ICG阴性但Tc阳性。使用ICG未引起任何副作用。
通过ICG荧光检测乳腺癌的SN是一种有前景、可靠的技术，但在获得与Tc技术相似的结果之前，仍需要一定程度的专业知识。
