Department of Gynecology, Rotkreuzklinikum München, Munich, Germany.
Department of Obstetrics & Gynecology, School of Medicine, Technical University of Munich, Munich, Germany.
J Surg Oncol. 2021 Mar;123(4):1092-1098. doi: 10.1002/jso.26338. Epub 2020 Dec 17.
To compare the detection rates of sentinel lymph nodes after converting the tracer technique from blue dye to indocyanine green (ICG).
Patients with uterine or cervical cancer were enrolled for sentinel lymph node (SLN) dissection. A total of 109 consecutive patients were analyzed and compared to a historical cohort of 109 consecutive patients with the sentinel blue dye technique. SLNs were analyzed by ultrastaging.
The bilateral mapping rate of sentinel nodes was significantly higher with the ICG (78%; n = 85) compared to the blue dye tracer (61%; n = 67; p = .006). Neither the mean number of SLN nor the rate of low volume metastases showed significant differences between both cohorts. In the subgroup of endometrial cancer patients, the number of systematic lymph node dissection (LND) was significantly lower in the ICG cohort compared to the blue dye cohort (9% vs. 28%, p = .001).
ICG improved the detection rate of pelvic SLN compared to blue dye and may be considered as the superior technique. In clinical practice, the rate of systematic LND further decreased after incorporating SLN mapping with ICG. Reliable safety data are still pending.
比较将示踪剂技术从蓝色染料转换为吲哚菁绿（ICG）后前哨淋巴结（SLN）的检出率。
纳入子宫或宫颈癌患者进行 SLN 解剖。共分析了 109 例连续患者，并与 109 例连续使用蓝色染料示踪剂的患者进行了历史队列比较。SLN 通过超分期进行分析。
与蓝色染料示踪剂（61%；n=67）相比，ICG 的双侧 SLN 定位率显著更高（78%；n=85；p=0.006）。两个队列之间的平均 SLN 数量和低体积转移率均无显著差异。在子宫内膜癌患者亚组中，ICG 队列的系统淋巴结清扫术（LND）数量明显低于蓝色染料队列（9%对 28%；p=0.001）。
与蓝色染料相比，ICG 提高了盆腔 SLN 的检出率，可被视为更优的技术。在临床实践中，在将 SLN 绘图与 ICG 结合后，系统 LND 的比率进一步降低。可靠的安全性数据仍在等待中。
