近红外荧光在乳腺癌前哨淋巴结活检中的应用现状

前哨淋巴结活检(sentinel lymph node biopsy,SLNB)已成为乳腺癌手术治疗的重要组成部分,其方法包括染料法、放射性核素法以及两者联合。但国内无批准的放射性示踪剂,使其临床推广受限。近红外荧光法依靠近红外光激发吲哚菁绿产生荧光,利用荧光显像装置来显像淋巴系统,能实时、动态检测皮下淋巴管和淋巴结,使得切口定位明确,组织损伤小,并可避免以上方法的诸多缺点,但需术中关闭无影灯,使手术时间延长,以及淬火效应导致荧光亮度衰减、探测深度受限等问题。另外,与染料法联合应用以提高前哨淋巴结检出率等问题,尚需l缶床试验进一步验证。

The application of near-infrared fluorescent method in sentinel lymph node biopsy of breast cancer

Sentinel lymph node biopsy has been an important part of breast cancer surgery,which includes reactive dye method,radionuclide method and the combination of both. However,the radionucli-ded tracer is not approved domestically,which limits its clinical application. Near-infrared fluorescent method depends on near-infrared light. It activates indocyanine green to produce fluorescence and then flu-orescent image device can be used to observe the lymphatic system,which is a real time and dynamic de-tection for lymphangion and lymph node. Furthermore,the definite incision site can be located,which less-ens the damage of tissues. The fluorescent method can avoid some disadvantages of the above methods. However,the shadowless lamp should be turned off during the operation,which prolongs the operation time. Due to the quenching effect,the brightness of fluorescence will attenuate and the detected depth will be limited. Combination of near-infrared fluorescence method and reactive dye method may improve the detection,but further large-scale clinical trials are required for confirmation.