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背景与目的:前哨淋巴结活检已成为临床腋淋巴结阴性早期乳腺癌患者的标准处理模式,并对疾病的分期和治疗方案的选择至关重要。该研究将吲哚菁绿和利妥昔单抗进行偶联作为新型示踪剂,采用小鼠后肢引流作为动物模型,模拟乳腺癌前哨淋巴结活检术,探索其定位效应。方法:小鼠后肢脚背皮下注射不同剂量的示踪剂,应用荧光脉管系统成像仪连续观测腘窝淋巴结(作为前哨淋巴结)至3 h,探索最佳注射剂量和显像时间。注射最佳剂量的示踪剂,观察至24 h,探索其持续定位效应。结果:随着注射剂量的增加,前哨淋巴结开始显像与达到最佳显像的时间均逐渐缩短,次级及第3级淋巴结显像率逐渐升高。新型示踪剂的最佳注射剂量为0.12μg(吲哚菁绿的含量),达最佳显像时间约为34 min。观察至24 h,前哨淋巴结显像率维持在100%,次级及第3级淋巴结显像率由6 h的0%和0%上升至20%和10%。结论:吲哚菁绿-利妥昔单抗能清晰定位前哨淋巴结且6 h内无次级淋巴结显像,具有较高的临床应用价值。
BACKGROUND & OBJECTIVE: Sentinel lymph node biopsy has become the standard treatment for patients with clinically axillary lymph node-negative early-stage breast cancer and is crucial for the staging of disease and the choice of treatment options. In the present study, indocyanine green and rituximab were used as a new tracer. Mouse hindlimb drainage was used as an animal model to simulate breast cancer sentinel lymph node biopsy and explore its localization effect. Methods: The mice were injected subcutaneously with different dosages of tracer into the instep of the hind limbs. The popliteal lymph nodes (as sentinel nodes) were observed continuously by fluorescence vasculature system for 3 hours to explore the optimal injection dose and imaging time. The best dose of tracer was injected and observed for 24 h, to explore its continuous positioning effect. Results: With the increase of injection dose, the onset time of sentinel lymph node imaging and optimal imaging were gradually shortened, and the imaging rates of secondary and grade 3 lymph nodes increased gradually. The best tracer injection dose of 0.12μg (indocyanine green content), the best imaging time of about 34 min. Observed by 24 h, the imaging rate of sentinel lymph node was 100%. The rates of secondary and tertiary lymph node imaging increased from 0% and 0% of 6 h to 20% and 10% respectively. CONCLUSION: Indocyanine green-rituximab can clearly locate sentinel lymph nodes and has no secondary lymph node imaging within 6 h, which has a high clinical value.