Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University＆ Hebei Key Laboratory of Stomatology＆ Hebei Clinical Research Center for Oral Diseases＆ Hebei Technology Innovation Center of Oral Health, Shijiazhuang, 050017, China.
Department of Orthodontics, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
Eur J Surg Oncol. 2024 Jun;50(6):108340. doi: 10.1016/j.ejso.2024.108340. Epub 2024 Apr 20.
To address the limitations of conventional sentinel lymph node biopsy (SLNB), a novel hybrid tracer (indocyanine green [ICG]-Tc-nanocolloid) has been developed. This meta-analysis aimed to compare the differences between the novel hybrid tracer and conventional methods using ICG or radioisotope (RI) for SLNB in head and neck malignancies. This study was registered in the International Prospective Register of Systematic Reviews (CRD42023409127). PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched. This study included raw data on the number of sentinel lymph nodes (SLNs) identified using different modalities during surgery for head and neck malignancies. The identification rate of SLNs was the main outcome of interest. Prognostic data and complication rate cannot be deduced from this article. The heterogeneity test (I) determined the use of a fixed- or random-effects model for the pooled risk ratio (RR). Overall, 1275 studies were screened, of which 11 met the inclusion criteria for the meta-analysis. In SLN identification of head and neck malignancies, ICG-Tc-nanocolloid was superior to ICG or RI. In the subgroup analyses, the detection rates of ICG and RI tracers in SLNB were comparable, regardless of the device, tumor type, or tumor stage. In conclusion, in SLN identification of head and neck malignancies, the use of ICG-Tc-nanocolloid is superior to the single technique of ICG or RI. This study suggests that Hospitals using ICG or RI may find it beneficial to change their practice to ICG-Tc-nanocolloid, especially in the head and neck area, owing to its superior effectiveness.
为了解决传统前哨淋巴结活检（SLNB）的局限性，开发了一种新型混合示踪剂（吲哚菁绿[ICG]-Tc-纳米胶体）。本荟萃分析旨在比较新型混合示踪剂与常规方法在头颈部恶性肿瘤中使用 ICG 或放射性同位素（RI）进行 SLNB 的差异。本研究在国际前瞻性系统评价注册库（CRD42023409127）中进行了注册。系统检索了 PubMed、Embase、Web of Science 和 Cochrane Library。本研究包括使用不同方式在头颈部恶性肿瘤手术中识别前哨淋巴结（SLN）数量的原始数据。SLN 的识别率是主要观察结果。本文无法推断预后数据和并发症发生率。异质性检验（I）确定了用于汇总风险比（RR）的固定或随机效应模型的使用。总体而言，筛选了 1275 项研究，其中 11 项符合荟萃分析的纳入标准。在头颈部恶性肿瘤的 SLN 识别中，ICG-Tc-纳米胶体优于 ICG 或 RI。在亚组分析中，无论设备、肿瘤类型或肿瘤分期如何，ICG 和 RI 示踪剂在 SLNB 中的检测率均相当。总之，在头颈部恶性肿瘤的 SLN 识别中，使用 ICG-Tc-纳米胶体优于 ICG 或 RI 单一技术。本研究表明，使用 ICG 或 RI 的医院可能会发现将其实践改为 ICG-Tc-纳米胶体会受益，特别是在头颈部区域，因为其效果更好。
