The Sarcoma, Melanoma and Rare Tumours Unit, The Royal Marsden Hospital and Institute Cancer of Research, London, UK.
Ann Surg Oncol. 2023 Jul;30(7):4333-4340. doi: 10.1245/s10434-023-13405-7. Epub 2023 Apr 16.
The use of indocyanine green (ICG) and near-infrared fluorescence imaging is a promising option for sentinel lymph node (SLN) mapping in cutaneous melanoma. The study objective was to compare the performance of ICG and blue dye at detecting SLNs with radioisotope nanocolloid (technetium-99).
Between April 2018 and June 2022, 293 consecutive patients with cutaneous melanoma (Breslow thickness ≥ 0.8 mm) underwent wide local excision and SLN biopsy. Patients were divided into group A (ICG; n = 122) and group B (blue dye; n = 163). All patients underwent SPECT/CT imaging preoperatively. SLN detection parameters and complications were compared between the groups.
A total of 285 patients had complete data and were included in the analysis. The median age was 62.0 (range 10-91) years, and 139 (48.8%) were female patients. The mean Breslow thickness was 2.6 mm, 89 (31.2%) patients had ulceration, and 179 (62.8%) patients had mitosis ≥ 1 mm. The mean number of SLNs detected per patient in group A was 1.58 and group B was 1.48. In groups A and B, the SLN detection rate was 96.7% versus 89.6% (p = 0.022) and the pathological SLN detection rate was 92.3% versus 97.1% (p = 0.481), respectively.
ICG had a higher SLN detection rate and equal pathological SLN detection rate to blue dye. ICG may not be inferior to blue dye and is a useful adjunct to radioisotope in SLN biopsy in cutaneous melanoma.
吲哚菁绿（ICG）和近红外荧光成像在皮肤黑色素瘤的前哨淋巴结（SLN）示踪中是一种很有前途的选择。本研究的目的是比较 ICG 和蓝色染料与放射性同位素胶体（锝-99）检测 SLN 的性能。
在 2018 年 4 月至 2022 年 6 月期间，293 例连续的皮肤黑色素瘤（Breslow 厚度≥0.8mm）患者接受了广泛的局部切除和 SLN 活检。患者分为 A 组（ICG；n=122）和 B 组（蓝色染料；n=163）。所有患者均在术前进行 SPECT/CT 成像。比较两组之间的 SLN 检测参数和并发症。
共有 285 例患者具有完整的数据并纳入分析。患者的中位年龄为 62.0 岁（范围 10-91 岁），139 例（48.8%）为女性。平均 Breslow 厚度为 2.6mm，89 例（31.2%）患者有溃疡，179 例（62.8%）患者有核分裂≥1mm。A 组和 B 组患者平均每人检出的 SLN 数分别为 1.58 个和 1.48 个。A 组和 B 组的 SLN 检出率分别为 96.7%和 89.6%（p=0.022），病理 SLN 检出率分别为 92.3%和 97.1%（p=0.481）。
ICG 的 SLN 检出率较高，与蓝色染料的病理 SLN 检出率相等。ICG 可能不逊于蓝色染料，是皮肤黑色素瘤 SLN 活检中放射性同位素的有用辅助手段。
