Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China.
Medicine (Baltimore). 2024 Aug 30;103(35):e39240. doi: 10.1097/MD.0000000000039240.
We evaluated the efficacy of indocyanine green fluorescence imaging compared to that of traditional nanocarbon dyes in assessing peri-intestinal lymph node metastasis in patients with colorectal cancer, which is a key prognostic factor. The relationship between indocyanine green fluorescence imaging and histopathological outcomes in patients with colon cancer has also been explored. A retrospective analysis was conducted on 30 patients with colon cancer (from May to October 2023) confirmed by surgical pathology. Tumors were marked with indocyanine green (ICG) or nanocarbon via colonoscopy 16 to 24 hours before surgery. Within 15 minutes after surgery, peri-intestinal lymph node fluorescence imaging and hematoxylin and eosin staining were used to assess the distribution of cancer foci. The correlation between cancer foci distribution, fluorescence intensity, and area under the receiver operating characteristic curve was measured. Among 243 metastatic lymph nodes from 30 patients, 18 were found. After the patients were divided into metastatic and nonmetastatic groups, significant differences in tumor differentiation and stage were noted (P < .001). The fluorescence intensity was strongly correlated with the presence and proportion of metastasis (area under the receiver operating characteristic curve = 0.931), whereas nanocarbon staining showed no significant correlation (P = .81). All P values were two-sided, with P < .05 indicating statistical significance. Lymph nodes with malignant intestinal tumor metastasis displayed weaker ICG fluorescence than did nonmetastatic nodes. Combining ICG and nanocarbon staining techniques enhances intraoperative lymph node dissection and postoperative analysis, indicating their potential utility in colorectal cancer surgery.
我们评估了吲哚菁绿荧光成像与传统纳米碳染料在评估结直肠癌患者的周围肠淋巴结转移中的疗效，这是一个关键的预后因素。还探讨了吲哚菁绿荧光成像与结肠癌患者的组织病理学结果之间的关系。对 30 例经手术病理证实的结肠癌患者（2023 年 5 月至 10 月）进行了回顾性分析。肿瘤通过结肠镜检查在手术前 16 至 24 小时用吲哚菁绿（ICG）或纳米碳进行标记。手术后 15 分钟内，使用周围肠淋巴结荧光成像和苏木精和伊红染色评估癌灶的分布。测量了癌灶分布、荧光强度和受试者工作特征曲线下面积之间的相关性。在 30 例患者的 243 个转移性淋巴结中，发现了 18 个。将患者分为转移性和非转移性组后，发现肿瘤分化和分期存在显著差异（P <.001）。荧光强度与转移的存在和比例呈强相关（受试者工作特征曲线下面积=0.931），而纳米碳染色则无明显相关性（P =.81）。所有 P 值均为双侧，P <.05 表示具有统计学意义。具有恶性肠道肿瘤转移的淋巴结的 ICG 荧光强度弱于非转移性淋巴结。结合 ICG 和纳米碳染色技术可增强术中淋巴结清扫和术后分析，表明其在结直肠癌手术中有潜在的应用价值。
