Department of Thyroid and Breast Surgery, Yijishan Hospital of Wannan Medical College, Zheshan West Road No. 2, Wuhu, 241001, Anhui Province, China.
World J Surg Oncol. 2022 Nov 9;20(1):357. doi: 10.1186/s12957-022-02827-4.
To evaluate the feasibility and accuracy of near-infrared fluorescence imaging technology for assessing margins during breast-conserving surgery for breast cancer.
Forty-three breast cancer patients who received surgical treatment at Yijishan Hospital of Wannan Medical College were selected. Before the operation, the patients were administered with an indocyanine green injection of 0.5 mg/kg intravenously 2 h before operation. During and after the operation, all patients underwent surgical margin monitoring with the near-infrared fluorescence imaging system for fluorescence imaging and acquisition of images and quantitative fluorescence intensity. During the operation, the patients' tissue specimens were collected on the upper, lower, inner, outer, apical, and basal sides of the fluorescence boundary of the isolated lesions for pathological examination.
Fluorescence was detected in the primary tumor in all patients. The average fluorescence intensities of tumor tissue, peritumoral tissue, and normal tissue were 219.41 ± 32.81, 143.35 ± 17.37, and 105.77 ± 17.79 arbitrary units, respectively (P < 0.05, t test). The signal-to-background ratio of tumor to peritumor tissue and normal tissue was 1.54 ± 0.20 and 2.14 ± 0.60, respectively (P < 0.05, t test). Abnormal indocyanine green fluorescence was detected in 11.6% patients (5/43), including 3 patients with residual infiltrating carcinoma and 2 patients with adenosis with ductal dilatation.
This study confirms the high sensitivity and specificity of near-infrared fluorescence imaging technology for breast-conserving surgery margin assessment. Near-infrared fluorescence imaging technology can be used as an intraoperative diagnosis and treatment tool to accurately determine the surgical margin and is of important guiding value in breast-conserving surgery for breast cancer.
评估近红外荧光成像技术在评估乳腺癌保乳手术切缘中的可行性和准确性。
选取皖南医学院弋矶山医院接受手术治疗的 43 例乳腺癌患者。术前 2 h 静脉注射吲哚菁绿 0.5 mg/kg。手术过程中和手术后，所有患者均使用近红外荧光成像系统进行手术切缘监测，进行荧光成像和图像采集以及定量荧光强度采集。手术过程中，在隔离病变的荧光边界的上下、内外、尖、基底侧采集患者的组织标本进行病理检查。
所有患者的原发肿瘤均检测到荧光。肿瘤组织、肿瘤周围组织和正常组织的平均荧光强度分别为 219.41 ± 32.81、143.35 ± 17.37 和 105.77 ± 17.79 任意单位（P < 0.05，t 检验）。肿瘤与肿瘤周围组织和正常组织的信号背景比分别为 1.54 ± 0.20 和 2.14 ± 0.60（P < 0.05，t 检验）。11.6%（5/43）的患者检测到异常吲哚菁绿荧光，包括 3 例残留浸润性癌和 2 例伴导管扩张的腺病。
本研究证实了近红外荧光成像技术在保乳手术切缘评估中的高灵敏度和特异性。近红外荧光成像技术可作为术中诊断和治疗工具，准确判断手术切缘，对乳腺癌保乳手术具有重要的指导价值。
