口腔生物医学 ›› 2021, Vol. 12 ›› Issue (2): 124-127.

• 论著 • 上一篇    下一篇

近红外荧光导航技术在口腔癌手术中应用的初步研究

孙立凡,王义洲,韩微,祝庆海,侯辰兴,叶金海   

  1. 南京医科大学附属口腔医院颌面外科
  • 收稿日期:2021-03-08 修回日期:2021-06-01 出版日期:2021-06-25 发布日期:2021-06-25
  • 通讯作者: 孙立凡 E-mail:slf75421@163.com
  • 基金资助:
    江苏高校优势学科建设工程项目

Application of near infrared fluorescence navigation technology in oral cancer surgery

  • Received:2021-03-08 Revised:2021-06-01 Online:2021-06-25 Published:2021-06-25
  • Contact: 孙立凡 sunlifan E-mail:slf75421@163.com

摘要: 目的:评估近红外荧光导航技术在口腔癌手术中及其手术边界的应用价值。方法:本研究选取14例于南京医科大学附属口腔医院就诊并接受手术治疗的口腔鳞癌患者。每例患者术前6~8?h静脉注射吲哚菁绿注射液0.75?mg/kg。术中、术后使用近红外荧光影像系统进行观测并拍照记录。术后在离体病灶荧光边界内、外侧收取组织标本进行病理学检查。结果:所有患者的病灶均可见肿瘤荧光显影,术后离体病灶的肿瘤背景比值(1.58±0.52)明显高于术中病灶的肿瘤背景比值(1.39±0.39)(P<0.05)。在荧光边界处,其区分正常上皮与非正常上皮(不典型增生及癌组织)的敏感性和特异性分别为83.3%和57.9%。结论:近红外荧光技术可用于检测口腔癌原发灶切除后是否残存肿瘤,可作为确定手术边界的诊疗辅助工具。

关键词: 近红外荧光, 吲哚菁绿, 口腔癌, 手术边界

Abstract: Objective: To evaluate the application value of near infrared fluorescence navigation technology in oral cancer surgery and its surgical margin. Methods: Fourteen patients with oral cancer who received surgical treatment in the Stomatological Hospital of Nanjing Medical University were selected in this study. Each patient received 0.75?mg/Kg indocyanine green injection intravenously 6-8h before surgery. Near infrared fluorescence imaging system was used to observe and record during and after operation. Specimens were collected within and outside the fluorescence boundary of the isolated lesions for pathological examination after surgery. Results: Fluorescence imaging was observed in all the lesions, and the tumor background ratio (1.58±0.52) was significantly higher than that of the intraoperative lesions (1.39±0.39) (P<0.05). At the fluorescence boundary, the sensitivity and specificity of differentiating normal epithelium from abnormal epithelium (dysplasia and cancer tissues) were 83.3% and 57.9% respectively. Conclusions: NIR fluorescence technique can be used to detect the residual tumor after the resection of the primary oral cancer, and it is expected to be an auxiliary tool to assist clinicians in determining the surgical margin.

Key words: near-infrared fluorescence, indocyanine, oral squamous cell carcinoma, surgery