General and Colorectal Surgery Division, Department of Cardiothoracic, Vascular Surgery and Organ Transplantation, Policlinico Umberto I University Hospital, Sapienza University of Rome, Rome, Italy.
IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France.
Minim Invasive Ther Allied Technol. 2022 Feb;31(2):223-229. doi: 10.1080/13645706.2020.1798464. Epub 2020 Jul 31.
Sentinel lymph node (SLN) mapping using near-infrared fluorescence (NIRF) imaging is a recent technique to improve nodal staging in several tumors. The presence of colorectal cancer (CRC) micro-metastases has recently been defined as N1 disease and no longer as N1mi, determining the need for adjuvant chemotherapy. In CRC, the reported rate of SLN micro-metastases detected by ultrastaging techniques is as high as 30%. The aim of this prospective study is to report the preliminary results of the sensitivity analysis of NIRF imaging for SLN mapping and the research of micro-metastases in CRC, in patients with node-negative disease (NND).
On the specimen of 22 CRC patients, 1 mL of ICG (5 mg/mL) was injected submucosally around the tumor to identify SLNs. NND SLNs were further investigated with ultrastaging techniques.
Three-hundred and sixty-three lymph nodes were retrieved (59 SLNs; mean per case: 2.7). The detection, sensitivity and false-negative rate were 100%, 100% and 0% respectively. Ultrastaging investigations showed no micro-metastases in the NND SLNs.
The SLN fluorescence-based detection in CRC was confirmed to be easy to perform and reliable. In this preliminary results report of an ongoing study, the SLN assay was congruent with the nodal status, as confirmed by histological investigations.
使用近红外荧光（NIRF）成像进行前哨淋巴结（SLN）测绘是一种最近的技术，可以提高几种肿瘤的淋巴结分期。结直肠癌（CRC）微转移的存在最近被定义为 N1 疾病，而不再是 N1mi，这决定了是否需要辅助化疗。在 CRC 中，通过超分期技术检测到 SLN 微转移的报告率高达 30%。本前瞻性研究旨在报告 NIRF 成像用于 SLN 测绘和 CRC 微转移研究的初步结果，该研究针对无淋巴结转移疾病（NND）的患者。
在 22 例 CRC 患者的标本上，在肿瘤周围黏膜下注射 1mL 的 ICG（5mg/mL）以识别 SLN。NND 的 SLN 进一步用超分期技术进行研究。
共取出 363 个淋巴结（59 个 SLN；平均每个病例 2.7 个）。检测、灵敏度和假阴性率分别为 100%、100%和 0%。超分期研究显示 NND 的 SLN 中没有微转移。
CRC 中基于 SLN 荧光的检测被证实易于操作且可靠。在这项正在进行的研究的初步结果报告中，SLN 检测与组织学检查确认的淋巴结状态一致。
