Study on the Application of Indocyanine Green Fluorescence Guided Laparo-scopic Lymph Node Resection in Clinical Early Stage Cervical Cancer Staging Surgery
- VernacularTitle:吲哚菁绿荧光指引腹腔镜淋巴结切除在临床早期子宫颈癌分期手术中的应用研究
- Author:
Biao TANG
1
;
Xiaoyan REN
;
Ling WU
;
Jun CHANG
;
Shaolan YU
;
Wenjuan WU
;
Qiufan LI
;
Gang WANG
Author Information
1. 四川省妇幼保健院·四川省妇女儿童医院·成都医学院附属妇女儿童医院妇科,四川成都 610043
- Keywords:
Indocyanine green;
Lymph tracer;
Cervical cancer;
Surgery pathological staging;
Laparoscopic surgery
- From:
Journal of Practical Obstetrics and Gynecology
2024;40(9):734-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and application value of indocyanine green(ICG)lymph node tracer in clinical early stage cervical cancer staging surgery.Methods:A retrospective analysis was performed on 31 patients with early clinical stage(ⅠA1-ⅡA1)cervical cancer who underwent laparoscopic radical hysterectomy,pelvic lymph node resection and para-aortic lymph node sampling were selected as the study subjects in Sichuan Provincial Maternal and Child Health Care Hospital from April 1,2022 to July 31,2023.They were divided into the ICG fluorescence tracer group(ICG group,17 cases)and the conventional surgery group(control group,14 ca-ses)based on whether ICG was injected or not.The resected lymph nodes were classified and submitted for ex-amination according to location and whether they presented visualization.The method of contingency coefficient was used to analyze the correlations between lymph node visualization patterns and lymph node metastasis and clinicopathological characteristics,and the perioperative data of the two groups were compared.Results:①The postoperative stage of 8 patients(25.8%)(4 in each group)were improved compared with the preoperative clini-cal stage.The number of resected lymph nodes in the ICG group was less than that in the control group(18±9 nodes/person vs.26±11 nodes/person,P<0.05).There were no statistically significant differences in operation time,intraoperative blood loss,postoperative FIGO(2018)staging,lymph node metastasis rate,and positive rate of resected lymph nodes between the two groups(P>0.05).②The visualization rate in the ICG group was 64.71%(11/17).There was no statistically significant difference in the positive rate between the visualized and non-visualized lymph nodes(P>0.05).There was a significant correlation between lymph node visualization and lymph node metastasis(C=0.707,P<0.05),and a significant correlation was found between lymph node visual-ization and lymph node metastasis in the same patient(C=0.557,P<0.05).Conclusions:The rate of lymph node metastasis in clinical early stage cervical cancer is low.ICG fluorescence visualization can trace lymph nodes and predict the risk of metastasis.By only resecting the visualized lymph nodes under the guidance of ICG tracer,the lymph node metastasis status of early-stage cervical cancer can be fully evaluated,which is worthy of further research.