Department of Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Otolaryngol Head Neck Surg. 2020 Mar;162(3):410-413. doi: 10.1177/0194599819900264. Epub 2020 Feb 11.
In this study, we sought to evaluate the clinical feasibility of indocyanine green (ICG)-guided sentinel lymph node (SLN) sampling during robotic retroauricular neck dissection (RAND) in patients with cN0 oral cancer. Nine adult patients diagnosed with T1 to T2 oral squamous cell carcinoma were consecutively recruited. All of them underwent transoral partial glossectomy and robotic RAND (levels I-III) simultaneously. Twelve hours prior to surgery, ICG was injected into the 4 quadrants around primary tongue tumors. During robotic RAND, intraoperative and ex vivo ICG-stained LNs were identified using the Firefly system and examined for the presence of fluorescence. ICG-stained LNs were identified in all patients. Thirty-one ICG-stained LNs were detected in 313 retrieved LNs (9.9%). Occult metastases were detected among the ICG-stained LNs in 2 patients (22.2%). There was no metastasis identified in the ICG-unstained LNs. Upstaging rates, sensitivity, specificity, and negative predictive value of ICG-guided SLN sampling were 22.2%, 100%, 91.5%, and 100%, respectively.
在这项研究中，我们旨在评估在机器人耳后颈部解剖术（RAND）中使用吲哚菁绿（ICG）引导前哨淋巴结（SLN）取样的临床可行性，该方法适用于 cN0 口腔癌患者。连续招募了 9 名被诊断为 T1 至 T2 口腔鳞状细胞癌的成年患者。所有患者均接受经口部分舌切除术和机器人 RAND（I-III 级）手术。手术前 12 小时，在原发舌肿瘤的 4 个象限周围注射 ICG。在机器人 RAND 过程中，使用 Firefly 系统识别术中及离体 ICG 染色的淋巴结，并检查荧光的存在。所有患者均能识别出 ICG 染色的淋巴结。在 313 个检出的淋巴结中，共检出 31 个 ICG 染色的淋巴结（9.9%）。在 2 名患者（22.2%）的 ICG 染色淋巴结中发现隐匿性转移。在 ICG 未染色的淋巴结中未发现转移。ICG 引导的 SLN 取样的分期升级率、敏感性、特异性和阴性预测值分别为 22.2%、100%、91.5%和 100%。
