内镜超声与吲哚菁绿荧光成像对结直肠癌前哨淋巴结及淋巴结转移的诊断价值
Diagnostic value of endoscopic ultrasound versus indocyanine green fluorescence imaging for sentinel and lymph node metastasis in patients with colorectal cancer.
作者信息
Wu Guocong, Huang Yu, He Meifeng, Ren Chenggang, Wang Zhuo, Liu Yangyang, Zhang Yao, He Jianyong, Liu Shaoshuai, Jia Zhengeng
机构信息
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of General Surgery, Beijing Jiangong Hospital, Beijing, China.
出版信息
J Gastrointest Oncol. 2025 Aug 30;16(4):1474-1482. doi: 10.21037/jgo-2024-917. Epub 2025 Aug 27.
BACKGROUND
Sentinel lymph nodes and lymph node metastases in patients with colorectal cancer (CRC) seriously affect prognosis. In order to improve the accuracy of lymph node assessment during surgery, it is crucial to explore advanced imaging techniques. This study aimed to evaluate the diagnostic value of endoscopic ultrasound (EUS) versus indocyanine green (ICG) fluorescence imaging for sentinel lymph node metastasis (SLNM) and lymph node metastasis (LNM) in patients with CRC.
METHODS
A total of 120 patients with CRC admitted to our hospital from March 2022 to December 2023 were included in this retrospective study and, according to the detection method, they were divided into ICG group (ICG fluorescence imaging group, n=50) and control group (EUS group, n=70). The general data of patients, sensitivity, specificity, and accuracy of ICG imaging for the diagnosis of SLNM and LNM in patients with CRC were statistically compared between the two groups using gold standard postoperative pathology reports. Area under receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of ICG fluorescence imaging for SLNM and LNM in patients with CRC.
RESULTS
For diagnosing SLNM in CRC patients, ICG fluorescence imaging achieved sensitivities, specificities, and accuracies of 94.44%, 93.75%, and 94.00%, respectively, significantly outperforming EUS, which achieved sensitivities, specificities, and accuracies of 40.74%, 69.77%, and 58.58% respectively. For LNM diagnosis, ICG fluorescence imaging showed sensitivities, specificities, and accuracies of 80.00%, 92.5%, and 90.00%, compared to 28.57%, 71.43%, and 62.86% for EUS. The area under curve (AUC) of ICG for LNM in patients with CRC was 0.932 with an optimal cut-off value of 0.77, achieving sensitivities and specificities of 95.45% and 81.82%.
CONCLUSIONS
In the assessment of SLNM and LNM in patients with CRC, ICG fluorescence imaging is proven to be more valuable than EUS.
背景
结直肠癌（CRC）患者的前哨淋巴结和淋巴结转移严重影响预后。为提高手术中淋巴结评估的准确性，探索先进的成像技术至关重要。本研究旨在评估内镜超声（EUS）与吲哚菁绿（ICG）荧光成像对CRC患者前哨淋巴结转移（SLNM）和淋巴结转移（LNM）的诊断价值。
方法
本回顾性研究纳入了2022年3月至2023年12月在我院收治的120例CRC患者，根据检测方法将其分为ICG组（ICG荧光成像组，n = 50）和对照组（EUS组，n = 70）。采用术后病理报告这一金标准，对两组患者的一般资料、ICG成像诊断CRC患者SLNM和LNM的敏感性、特异性及准确性进行统计学比较。采用受试者操作特征（ROC）曲线下面积分析ICG荧光成像对CRC患者SLNM和LNM的诊断价值。
结果
对于诊断CRC患者的SLNM，ICG荧光成像的敏感性、特异性和准确性分别为94.44%、93.75%和94.00%，显著优于EUS，EUS的敏感性、特异性和准确性分别为40.74%、69.77%和58.58%。对于LNM诊断，ICG荧光成像的敏感性、特异性和准确性分别为80.00%、92.5%和90.00%，而EUS分别为28.57%、71.43%和62.86%。CRC患者LNM的ICG曲线下面积（AUC）为0.932，最佳截断值为0.77，敏感性和特异性分别为95.45%和81.82%。
结论
在评估CRC患者的SLNM和LNM时，ICG荧光成像被证明比EUS更有价值。
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