Department of Surgery, Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, South Korea.
Department of Nuclear Medicine, National Cancer Center, Goyang, South Korea.
Sci Rep. 2021 May 11;11(1):9997. doi: 10.1038/s41598-021-89423-w.
We investigated localization and safe resection margins for breast cancer patients undergoing breast conserving surgery (BCS) using ultrasound-guided indocyanine green fluorescence (ICG-F) marking. From April 2016 to March 2019, we prospectively enrolled 114 patients who underwent BCS using US-guided ICG-F marking and we compared these results with 300 patients who underwent BCS using US-guided skin marking from January 2012 to December 2016. Clinical features, identification rates, status of resection margins, and re-operation rates were analyzed. The ICG-F identification rate was 100% (114/114). The mean approach time for resection of the lesion ICG-F using group was about 13 min. The positive rate of frozen resection margins was 10.5% using ICG-F and 25.0% using sono-guided skin marking (p < 0.01). The rate of additional intraoperative resection was significantly lower in the ICG-F marking group compared to that in the sono-guided skin marking group (8.8% vs. 23.3%, p < 0.01). The rate of final positive resection margins was 3.5% in the ICG-F using group and 14.7% in the sono-guided skin marking group (p < 0.01). The rate of re-operation was 4.4% in the ICG-F using group and 4% in the sono-guided group (p = 0.79). At follow-up after the operation using ICG-F, no complications occurred. Using ICG-F during BCS could be a safe, sophisticated method for localization.
我们研究了使用超声引导吲哚菁绿荧光（ICG-F）标记的保乳手术（BCS）患者的定位和安全切缘。从 2016 年 4 月至 2019 年 3 月，我们前瞻性地纳入了 114 例接受 US 引导 ICG-F 标记的 BCS 患者，并将这些结果与 2012 年 1 月至 2016 年 12 月接受 US 引导皮肤标记的 300 例 BCS 患者进行比较。分析了临床特征、识别率、切缘状态和再次手术率。ICG-F 的识别率为 100%（114/114）。使用 ICG-F 切除病变的平均手术时间约为 13 分钟。使用 ICG-F 时冷冻切缘的阳性率为 10.5%，使用超声引导皮肤标记时为 25.0%（p<0.01）。与超声引导皮肤标记组相比，ICG-F 标记组术中额外切除的发生率显著降低（8.8%对 23.3%，p<0.01）。ICG-F 组最终阳性切缘率为 3.5%，超声引导皮肤标记组为 14.7%（p<0.01）。ICG-F 组的再次手术率为 4.4%，超声引导组为 4%（p=0.79）。在使用 ICG-F 的手术后随访中，没有发生并发症。在 BCS 中使用 ICG-F 可能是一种安全、复杂的定位方法。
