Correlation between indocyanine green fluorescence imaging and the positive rate of lymph node metastasis in radical cystectomy
10.3969/j.issn.1009-8291.2025.09.007
- VernacularTitle:膀胱癌根治术中吲哚菁绿荧光显像范围与淋巴结转移阳性率的相关性研究
- Author:
Hao WANG
1
;
Guowang DU
;
Yurui ZHANG
;
Xiaopeng WANG
;
Fengshuo YANG
;
Lifeng LIU
Author Information
1. 沧州市人民医院泌尿外科,河北沧州 061000
- Publication Type:Journal Article
- Keywords:
indocyanine green;
fluorescence imaging;
radical cystectomy;
lymph node metastasis;
bladder cancer
- From:
Journal of Modern Urology
2025;30(9):760-764
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation between indocyanine green(ICG)fluorescence imaging and lymph node metastasis of bladder cancer and its application value.Methods The clinicopathological data of 35 patients with bladder cancer(T1-T4aNxM0)treated in our hospital during Jun.2019 and Mar.2023 were collected.All patients underwent ICG submucous injection,and those with successful imaging received lymph node dissection under fluorescent guidance.After that,the remaining lymph tissue was cleared according to the standard lymph node dissection range,and the resected lymph tissue was subassembled for examination.Patients with non-imaging underwent standard pelvic lymph node dissection according to the routine procedure.Intraoperative lymph node imaging areas were recorded,and postoperative lymph node pathological data were collected.The correlation between fluorescence imaging patterns and lymph node metastasis in patients with different stages of bladder cancer was analyzed with correlation coefficients.Results The ICG fluorescence imaging rate was 91.43％(32/35),and there was no statistically significant difference in the imaging rate among patients with different stages of bladder cancer(P＞0.05).The fluorescence imaging range was significantly correlated with the stage(C=0.351,P=0.034).There was a significant correlation between the imaging range and lymph node metastasis in early-stage patients(C=0.619,P=0.022),but there was no significant difference in the lymph node metastasis rate in advanced patients with different imaging range(P＞0.05).In patients with full staging,the sensitivity of lymph nodes to predict metastasis was 60.00％(6/10),and the negative predictive value was 84.62％(22/26).In early-stage patients,the sensitivity and negative predictive value were 50.00％(1/2)and 93.75％(15/16),respectively.In advanced-stage patients,they were 62.50％(5/8)and 70.00％(7/10),respectively.Conclusion ICG fluorescence imaging rate of tracing lymph node metastasis is high,and the imaging range is significantly related to the tumor stage.For patients with early-stage(T1-T2)bladder cancer,the range of imaging helps to predict the risk of lymph node metastasis and guide the extent of lymph node dissection.Resection of multi-area imaged lymph nodes can comprehensively evaluate the lymphatic metastasis status of early-stage patients.
