Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Liaoning, P.R. China.
Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan.
Anticancer Res. 2020 Apr;40(4):1875-1882. doi: 10.21873/anticanres.14141.
The method of quickly identifying metastatic mediastinal lymph nodes has become an urgent problem for lung cancer surgery. Indocyanine green (ICG) has the characteristic of being retained in or around the lymph nodes; its pharmacokinetic characteristics and optimal imaging time have not yet been elucidated.
The IVIS Lumina Imaging System was used to detect near infrared (NIR) fluorescence signals at different ICG doses, times and excitation/emission wavelengths in vitro. An artificial lymphogenous metastatic model of squamous lung carcinoma was established in 32 SCID-CB17 mice using Ma44.3 cells. An intratracheal injection of 1.25 ml/kg ICG (1.25×10 mg/ml) was performed, then 780 nm Ex and 845 nm Em were used to visualize ICG at four different times. The metastatic mediastinal lymph nodes and the implanted local tumor site in the left lung were confirmed with bioluminescence and hematoxylin and eosin (H&E) staining of pathological specimens.
ICG had the strongest NIR fluorescence signal when using 780 nm Ex and 845 nm Em at 2 to 4 h after administrating 1.25×10 mg/ml ICG in vitro. Combined with pathological H&E examination, fluorescence imaging of ICG reflected true-positive mediastinal metastasis of the mediastinum at 0.5 h and 2 h after the injection of ICG in vivo. While true-positive local tumor growth at the site of implantation in the left lung was reflected within 4 h after the injection of ICG.
ICG was able to display the metastatic mediastinal lymph nodes within 2 h after endotracheal injection in an orthotopic squamous lung carcinoma implantation model.
快速识别转移性纵隔淋巴结的方法已成为肺癌手术的迫切问题。吲哚菁绿（ICG）具有在淋巴结内或周围滞留的特性；但其药代动力学特征和最佳成像时间尚未阐明。
在体外使用 IVIS Lumina 成像系统，以检测不同 ICG 剂量、时间和激发/发射波长下的近红外（NIR）荧光信号。使用 Ma44.3 细胞在 32 只 SCID-CB17 小鼠中建立了鳞状肺癌的人工淋巴转移模型。通过气管内注射 1.25 ml/kg 的 ICG（1.25×10 mg/ml），然后使用 780 nm Ex 和 845 nm Em 在四个不同时间可视化 ICG。使用生物发光和苏木精和伊红（H&E）染色的病理标本确认转移性纵隔淋巴结和左肺中的植入局部肿瘤部位。
在体外给予 1.25×10 mg/ml ICG 后 2 至 4 小时，使用 780 nm Ex 和 845 nm Em 时，ICG 具有最强的 NIR 荧光信号。结合病理 H&E 检查，ICG 的荧光成像反映了注射 ICG 后 0.5 小时和 2 小时时纵隔内真正阳性的纵隔转移。而在注射 ICG 后 4 小时内，反映了在左肺植入部位的真正阳性局部肿瘤生长。
在原位接种鳞状肺癌模型中，ICG 可在气管内注射后 2 小时内显示转移性纵隔淋巴结。
