Yokoyama Junkichi, Hasegawa Yasuhisa, Sugasawa Masashi, Shiotani Akihiro, Murakami Yoshiko, Ohba Shinichi, Kohno Naoyuki
Department of Otolaryngology-Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181-8611, Japan.
Department of Otolaryngology.Head and Neck Surgery, Nadogaya Hospital, Chiba 277-0084, Japan.
Mol Clin Oncol. 2020 Oct;13(4):41. doi: 10.3892/mco.2020.2111. Epub 2020 Aug 12.
In the current study, the utility of sentinel node (SN) identification using indocyanine green (ICG) was investigated for oral cancers in the clinical N0 stage. The current study was a prospective, multicentre, phase II clinical trial that was conducted in Japan. A total of 18 patients were included. Before surgery, the patients underwent lymphoscintigraphy to map the SNs. During surgery, radioactive isotope (RI) mapping was used to detect the SNs, and ICG was subsequently injected. ICG mapping of the SNs was then performed through the skin. The primary tumour was resected, and a neck flap was elevated for neck dissection, followed by SN biopsy (SNB) using RI or ICG mapping. With the RI method, a total of 63 SNs were detected. Among these SNs, 8 (12.7%) were positive for metastasis, including those with isolated tumour cells (ITCs). The median number of SNs per patient identified by SNB was 4. With the ICG method, a total of 67 SNs were detected. Among these SNs, 7 (10.4%) were positive for metastasis, including those with ITCs. The median number of SNs per patient identified by SNB was 4 (range, 1-6). The 5-year overall survival (OS) of all patients was 83.3%, and the 5-year disease-free survival (DFS) of all patients was 76.7%. The neck compression technique is a simple method that can be used to facilitate surgical procedures of ICG fluorescence navigated SNB for head and neck cancer.
在本研究中，对临床N0期口腔癌患者使用吲哚菁绿（ICG）进行前哨淋巴结（SN）识别的效用进行了研究。本研究是在日本进行的一项前瞻性、多中心、II期临床试验。共纳入18例患者。手术前，患者接受淋巴闪烁显像以绘制SN图谱。手术期间，使用放射性同位素（RI）图谱检测SN，随后注射ICG。然后通过皮肤进行SN的ICG图谱绘制。切除原发肿瘤，掀起颈部皮瓣进行颈部清扫，随后使用RI或ICG图谱进行SN活检（SNB）。采用RI方法，共检测到63个SN。在这些SN中，8个（12.7%）有转移阳性，包括那些有孤立肿瘤细胞（ITC）的。SNB确定的每位患者SN的中位数为4个。采用ICG方法，共检测到67个SN。在这些SN中，7个（10.4%）有转移阳性，包括那些有ITC的。SNB确定的每位患者SN的中位数为4个（范围为1 - 6个）。所有患者的5年总生存率（OS）为83.3%，所有患者的5年无病生存率（DFS）为76.7%。颈部压迫技术是一种简单的方法，可用于促进ICG荧光导航的SNB在头颈癌手术中的操作。
