Jiang Keyu, Luo Binlin, Hou Zuoqiong, Li Chujun, Cai Huiming, Tang Jian, Yao Gang
Department of Plastic and Burn Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Nanjing Nuoyuan Medical Devices Co., Ltd., Nanjing, China.
Ann Transl Med. 2021 Sep;9(18):1456. doi: 10.21037/atm-21-4366.
Regional lymph node status is an independent influencing factor for the prognosis of acral malignant melanoma, and the accuracy of sentinel lymph node biopsy (SLNB) is directly related to the judgment of regional lymph node status. This study aimed to explore the application value of indocyanine green (ICG) surgical fluorescence imaging system in the SLNB of acral malignant melanoma.
A total of 34 patients with acral malignant melanoma were admitted to the Department of Burn and Plastic Surgery in Jiangsu Provincial People's Hospital from January 2020 to March 2020. Among these patients, 22 required SLNB. ICG and methylene blue (MB) were combined to intraoperatively trace the sentinel lymph nodes (SLNs). The total number of SLNs detected during the operation was counted. We compared the number, detection rate, as well as the detection rate and false negative rate of positive SLNs of SLNs detected by ICG, MB, and ICG combined with MB.
A total of 56 SLNs were detected in the 22 patients, among which 55 were detected by ICG (98%), 41 were detected by MB (71%), and 56 (100%) were detected by ICG combined with MB, and the average number of SLNs were 2.5, 1.64, and 2.55, respectively. A total of nine SLNs were detected, of which nine were detected by ICG (100%), seven by MB (78%), and nine by ICG combined with MB (100%). Patients with negative SLNs had no recurrence at the 6-month follow-up.
Compared with MB, the ICG fluorescent imaging system can improve the detection rate of SLNs in patients with acral malignant melanoma. Also, ICG combined with MB was superior to ICG alone.
区域淋巴结状态是肢端恶性黑色素瘤预后的独立影响因素，前哨淋巴结活检（SLNB）的准确性直接关系到区域淋巴结状态的判断。本研究旨在探讨吲哚菁绿（ICG）手术荧光成像系统在肢端恶性黑色素瘤SLNB中的应用价值。
2020年1月至2020年3月，江苏省人民医院烧伤整形科共收治34例肢端恶性黑色素瘤患者，其中22例需要行SLNB。将ICG与亚甲蓝（MB）联合用于术中前哨淋巴结（SLN）示踪。统计手术中检测到的SLN总数。比较ICG、MB以及ICG联合MB检测SLN的数量、检出率，以及阳性SLN的检出率和假阴性率。
22例患者共检测到56枚SLN，其中ICG检测到55枚（98%），MB检测到41枚（71%），ICG联合MB检测到56枚（100%），平均SLN数量分别为2.5枚、1.64枚和2.55枚。共检测到9枚阳性SLN，其中ICG检测到9枚（100%），MB检测到7枚（78%），ICG联合MB检测到9枚（100%）。SLN阴性的患者在6个月随访时无复发。
与MB相比，ICG荧光成像系统可提高肢端恶性黑色素瘤患者SLN的检出率。此外ICG联合MB优于单独使用ICG。
