吲哚菁绿介导的近红外光检测技术在胆囊癌手术切除术中的应用  

Application of indocyanine green-mediated near-infrared light detection technique in patients undergoing cholecystectomy

作　　者：刘文博 张建业 保积武 刘震[2] Liu Wenbo;Zhang Jianye;Bao Jiwu(Department of General Surgery,Provincial Transportation Hospital,Xining 810000,Qinghai Province,China)

机构地区：[1]青海省交通医院普外科,西宁市810000 [2]青海大学附属医院肝胆外科

出　　处：《实用肝脏病杂志》2019年第4期573-576,共4页Journal of Practical Hepatology

基　　金：青海省自然科学基金资助项目(编号:2013-Z-938Q)

摘　　要：目的探讨吲哚菁绿介导的近红外光检测技术在胆囊外科手术治疗中的应用。方法采用前瞻性研究方法,收集2016年1月~2018年1月我院收治的45例预行外科手术治疗的胆囊癌患者的临床资料。术前给予静脉注射吲哚菁绿(0.5mg·kg^-1),观察患者术前发现肿瘤荧光显像情况;在离体标本,在肿瘤解剖面观察荧光显像特点;术后随访1年,观察术后肿瘤复发情况。结果在45例患者,术前发现45个肿瘤,其中37个能在体表区域呈现荧光,显现荧光患者肿瘤深度和肿瘤直径分别为(0.4±0.2)cm和(6.3±2.1)cm,与未显现荧光的8例患者【分别为(1.5±0.4)cm和(4.5±0.3)cm,P<0.05】比,差异显著;将45例离体肿瘤组织标本从中央剖开,剖面均显示出较强的荧光,其中23例高分化胆囊癌均为肿瘤实质显像,14例中分化癌中有4个为肿瘤实质显像,其余8例低分化胆囊癌组织均与肿瘤周围组织显像一致;术后随访1年,未发现死亡病例,其中7例(15.6%)患者肿瘤复发。结论吲哚菁绿介导的近红外光显像技术能够显示肿瘤位置,可探测到常常影响检查而遗漏的病灶,有助于对病灶的完全清除。Objective The aim of this study was to investigate the application of indocyanine green-mediated near-infrared light detection in patients undergoing cholecystectomy.Methods The clinical data of 45 patients with gallbladder carcinoma treated in our hospital between January 2016 and January 2018 were prospectively collected and analyzed.Intravenous injection of indocyanine green was given before surgery to guide finding the tumor fluorescence imaging during the operation.The anatomical features of the tumors in the isolated specimens were observed too.Results Forty-five tumors were found in 45 patients before operation,out of them,37 could show fluorescence in the surface of the tumors,and the depths and diameters of tumors with fluorescent manifestation were(0.4±0.2)cm and(6.3±2.1)cm,respectively,significantly different as compared to those in 8 tumors without fluorescent feature[(1.5±0.4)cm and(4.5±0.3)cm,respectively,P<0.05];in 45 patients,the in vitro tumor tissue specimens were cut open by the middle,and the sections showed strong fluorescence,among them,23 highly differentiated gallbladder carcinomas were with parenchymal imaging,4 out of 14 moderately differentiated carcinomas were with parenchymal imaging,and the other 8 poorly differentiated gallbladder carcinomas were without any imaging consistent with tumor surrounding tissue;at 1-year follow-up,no deaths were found,and 7(15.6%)patients had tumor recurrence.Conclusion Indocyanine green-mediated near-infrared light imaging could show the location of the tumors,helping find the lesions that are commonly neglected by the routine examination.

关 键 词：胆囊癌 手术切除 吲哚菁绿 近红外光检测 治疗 

分 类 号：R735.8[医药卫生—肿瘤]