Filippello Alexandre, Porcheron Jack, Klein Jean Philippe, Cottier Michèle, Barabino Gabriele
1 University Nord Hospital, Saint Etienne, France.
2 Jean Monnet University of Saint Etienne, Saint Etienne, France.
Surg Innov. 2017 Apr;24(2):103-108. doi: 10.1177/1553350616681897. Epub 2016 Dec 29.
Indocyanine green (ICG) is increasingly being used in digestive oncology. In colorectal cancer, ICG can be used to detect lymph node metastasis and hepatic metastasis on the surface of the liver. In peritoneal carcinomatosis, it was previously suspected that the diffusion of ICG in the tumor mass was due to the enhanced permeability and retention effect; however, this phenomenon has not been clearly demonstrated. Using bevacizumab, an antibody directed against vascular endothelial growth factor that consequently inhibits neoangiogenesis, we sought to confirm the mode of ICG diffusion. We compared the fluorescence of peritoneal carcinomatosis nodules from patients who had previously received bevacizumab during their oncologic treatment with those who did not receive this therapy. The sensitivity of the carcinomatosis nodule fluorescence was higher in the patients who did not receive bevacizumab compared with those who received the drug (76.3% and 65.0%, respectively). The rate of false-negative results was higher in the bevacizumab group than in the group that did not receive the drug (53.8% and 42.9%, respectively). Using bevacizumab, we demonstrate that the enhanced permeability and retention effect causes ICG accumulation in peritoneal carcinomatosis resulting from colorectal cancer.
吲哚菁绿（ICG）在消化肿瘤学中的应用日益广泛。在结直肠癌中，ICG可用于检测肝脏表面的淋巴结转移和肝转移。在腹膜癌病中，以往怀疑ICG在肿瘤块中的扩散是由于增强的通透性和滞留效应；然而，这一现象尚未得到明确证实。我们使用贝伐单抗（一种针对血管内皮生长因子的抗体，可抑制新生血管形成）来试图确认ICG的扩散方式。我们比较了在肿瘤治疗期间曾接受过贝伐单抗治疗的患者与未接受该治疗的患者腹膜癌病结节的荧光情况。未接受贝伐单抗治疗的患者中癌病结节荧光的敏感性高于接受该药治疗的患者（分别为76.3%和65.0%）。贝伐单抗组的假阴性结果率高于未接受该药治疗的组（分别为53.8%和42.9%）。通过使用贝伐单抗，我们证明增强的通透性和滞留效应会导致ICG在结直肠癌所致的腹膜癌病中蓄积。
