荧光实时示踪探测兔甲状腺引流淋巴结的实验研究  

Detection of lymph node of rabbit thyroid by real-time fluorescence imaging

作　　者：柳桢[1] 王家东[1] 周秦毅[1] 周争[1] 

机构地区：[1]上海交通大学医学院附属仁济医院耳鼻咽喉头颈外科、上海交通大学耳鼻喉科研究所,200001

出　　处：《中华耳鼻咽喉头颈外科杂志》2013年第1期61-65,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：上海市科学技术委员会科研计划资助项目（0852nm04000）

摘　　要：目的通过将荧光示踪剂吲哚花青绿（indocyaninegreen，ICG）注射人兔甲状腺中，观察兔甲状腺引流淋巴结成像的效果，为使用荧光探测法探测甲状腺癌患者的前哨淋巴结提供动物实验依据。方法25只实验兔共计50侧甲状腺，每侧甲状腺分别注射5ms／ml的ICG和10ms／ml的美蓝0．02ml。利用荧光实时成像设备观测注射ICG后淋巴结的检出情况，并与注射美蓝后淋巴结检出情况进行对比，采用Fisher确切概率法统计组间差异。记录注射ICG后淋巴结开始成像的时间。结果荧光探测法和美蓝探测法检出组织经病理确认为淋巴结的准确率分别为85．5％（53／62）和70．7％（41／58），经Fisher确切概率法检验差异无统计学意义（P=0．075）；两种方法的淋巴结检出率分别为86．O％（43／50）和66．0％（33／50），经Fisher确切概率法检验差异有统计学意义（P＝0．034）；甲状腺注射ICG至淋巴结开始荧光成像平均时间（x±S）为（118．3±16．1）s。结论荧光探测法探测兔甲状腺的引流淋巴结具有较高的检出率和准确率，淋巴结检出率高于美蓝探测法。荧光探测法可应用于临床以检测淋巴结。Objective To detect the lymph nodes （LN） of rabbit thyroid by fluorescence imaging and to provide experimental evidence for its clinical application. Methods Each of 50 lateral thyroid lobes of 25 rabbits was injected with 0.02 ml of indocyanine green（ ICG）, and 0.02 ml methylene followed. ICG fluorescence was detected using photodynamic eye（PDE）. The methylene staining in LN was also observed. The onset time of ICG staining in LN was measured. Results The detection rate of fluorescence imaging and blue dye imaging were respectively 86.0% （43/50） and 66.0% （33/50）, with a significant difference （P = 0. 034）, and the accuracy were respectively 85.5% （53/62） and 70.7% （41/58）. The onset time （x＋ s） of ICG staining in LN was （ 118.3 ± 16.1 ） s. Conclusions Fluorescence imaging showed satisfied detection rate and accuracy. The detection rate of LN by fluorescence imaging was higher than that by blue dye imaging. Fluorescence imaging could be an alternative method for the detection of LN of thyroid in future clinical practice.

关 键 词：甲状腺 淋巴结 荧光染料 吲哚花青绿 

分 类 号：R736.1[医药卫生—肿瘤]