吲哚菁绿的荧光显影特性在肝细胞癌患者的临床应用价值  

Clinical apllication of indocyanine green fluorescence imaging in patients with hepatocellular carcinoma

作　　者：王爽[1] 潘洁[1] 乐琪 汝黎明 冯留顺[1] 

机构地区：[1]郑州大学第一附属医院肝胆外科,450000

出　　处：《中华普通外科杂志》2017年第11期949-951,共3页Chinese Journal of General Surgery

摘　　要：目的探讨吲哚菁绿（indocyanine green，ICG）的荧光显像特性在肝细胞癌患者的临床应用价值。方法选取拟行肝脏切除术的患者65例，术前均诊断为肝细胞癌且均只有一个病灶，分为术前给药组28例和术中给药组37例，术前给药组于手术前2—14d给药，而术中给药组则为术中即刻给药．术中应用ICG介导的近红外光显像系统观察肿瘤的荧光显影情况，指导手术切缘的界定。结果术前给药组中，肿瘤呈明亮的荧光显影，正常肝组织不显影，术中新发现阳性病灶例数6例，阳性微小病灶10个，术后病理显示肝细胞癌4个，肝硬化结节5个，脂肪变性1个；术中给药组中，肿瘤均为边界清晰的暗影，新发现阳性例数8例，阳性微小病灶12个，术后病理回示肝细胞癌5个，肝硬化结节4个，脂肪变性2个，血管瘤1个。结论两者给药方式均可发现微小病灶，术前给药组中病灶的荧光显影方式可指导鉴别肿瘤的性质．而术中给药组在确定肿瘤边界方面更有价值。Objective To explore the clinical application of indocyanine green （ICG） fluorescence imaging in patients with hepatocellular carcinoma. Methods 65 hepatocellular carcinoma patients, all were with single lesion, were divided into two groups ： preoperative ICG administration group （ n = 28） and intraoperative ICG administration group （ n = 37 ） . In preoperative ICG administration group ICG was given 2 to 14 days before surgery, while in the intraoperative ICG administration group it was given during surgery. ICG mediated near-infrared imaging system was used to observe the tumor and determine surgical margin. Results In the preoperative group, tumors were bright fluorescent imaging, in 6 cases 10 new small lesions were found, with cancer diagnosed in 4 patients, cirrhotic liver nodule in 5 patients, fatty degeneration in 1 patient. In the intraoperative group, tumors were clearly demarcated shadow, 12 new small lesions were found in 8 cases, with cancer being diagnosed in 5 patients, cirrhotic liver nodule in 4 patients, fatty degeneration in 2 patients, hemangioma in I patient. Conclusion Both methods can find small lesions, preoperative administration group was better in identifying the nature of the tumor, while the intraoperative administration group was more valuable in determining the boundaries of the tumor.

关 键 词：癌 肝细胞 肝切除术 荧光显影技术 吲哚菁绿 

分 类 号：R735.7[医药卫生—肿瘤]