亚甲基蓝在胃肠肿瘤外科手术中应用的研究进展
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摘要
淋巴结转移是胃癌及结直肠癌最重要的预后指标之一,其转移情况决定了患者进一步的治疗方案.在胃肠道肿瘤中,准确的淋巴结分期十分重要.国内外的学者一直致力于寻找标记肿瘤转移淋巴结的材料,亚甲基蓝这一水溶性色素因其具有显色快,特异性较好等优点,近年来受到了外科医师及病理科医师的广泛关注,并被逐渐应用于胃肠道恶性肿瘤的淋巴结标记中.笔者就亚甲基蓝应用于胃肠肿瘤淋巴结标记的应用范围、给药途径、显影效果及进展作一综述.
Lymph node metastasis status is one of the most significant prognostic factors which decide the prognosis and further treatment of the patients. Therefore, the accurate lymph node stage is crucial. Researchers are trying to find methods to mark the metastatic lymph nodes. Methylene blue,a water-soluble pigment, draws surgeons' and pathologists' attention for its fast tinting, cost-effectivity and relatively high specificity. Recent years,the application of methylene blue for lymph nodes identification in gastrointestinal cancer is increasingly mature. This paper is to reviewed the application domains, administration methods, imaging effect and future development of methylene blue in gastrointestinal cancer lymph node imaging.
Lymph node metastasis status is one of the most significant prognostic factors which decide the prognosis and further treatment of the patients. Therefore, the accurate lymph node stage is crucial. Researchers are trying to find methods to mark the metastatic lymph nodes. Methylene blue,a water-soluble pigment, draws surgeons' and pathologists' attention for its fast tinting, cost-effectivity and relatively high specificity. Recent years,the application of methylene blue for lymph nodes identification in gastrointestinal cancer is increasingly mature. This paper is to reviewed the application domains, administration methods, imaging effect and future development of methylene blue in gastrointestinal cancer lymph node imaging.
引文
[1] TORRE L A,BRAY F,SIEGEL R L,et al. Global cancer statistics,2012[J].CA:A Cancer Journal for Clinicians,2015,65(2):87-108.
[2] CHEN W,ZHENG R,BAADE P D,et al. Cancer statistics in China,2015[J].CA:A Cancer Journal for Clinicians,2016,66(2):115-132.
[3] REIMA H,SAAR H,INNOS K,et al. Methylene blue intra-arterial staining of resected colorectal cancer specimens improves accuracy of nodal staging:A randomized controlled trial[J].Ejso,2016,42(11):1642-1646.
[4] FAROUK A,RASHAD R. Improved detection of lymph nodes in cases of rectal cancer using combined methylene blue injection and fat clearance compared with fat clearance alone[J].Egyptian Journal of Surgery,2017,36(4):340-345.
[5] JEPSEN R K,INGEHOLM P,LUND E L. Upstaging of early colorectal cancers following improved lymph node yield after methylene blue injection[J].Histopathology,2012,61(5):788-794.
[6] CABANAS R M. An approach for the treatment of penile carcinoma[J].Cancer,1977,39(2):456-466.
[7] LIU J,HUANG P,ZHENG Z,et al. Modified methylene blue injection improves lymph node harvest in rectal cancer[J].Anz Journal of Surgery,2017,87(4):247-251.
[8] MARTIN-LAZARO J,NUNEZ-ORJALES R,BATTIKHIPRECEDO N,et al. Allergy to blue dye[J].Journal of investigational allergology&clinical immunology,2016,26(6):381-383.
[9]吴殿文,王锡山.结直肠癌前哨淋巴结活检的临床意义[J].中华结直肠疾病电子杂志,2014,3(4):288-291.
[10] MOCELLIN S,MCCULLOCH P,KAZI H,et al. Extent of lymph node dissection for adenocarcinoma of the stomach[J].The Cochrane database of systematic reviews,2015,12(8):Cd001964.
[11] MOCELLIN S,NITTI D. Lymphadenectomy extent and survival of patients with gastric carcinoma:a systematic review and meta-analysis of time-to-event data from randomized trials[J].Cancer treatment reviews,2015,41(5):448-454.
[12]柯孔亮,戴永平,郭宇,等.亚甲蓝示踪技术在胃癌前哨淋巴结活检中的应用[J].现代实用医学,2015,27(5):623-625.
[13]吴凯,刘伟,冯旭刚,马龙安.前哨淋巴结定位检测在早期诊断进展期胃癌中的作用分析[J].海南医学院学报,2015,21(6):805-807.
[14] LIANOS G D,HASEMAKI N,VAGGELIS G,et al. Sentinel node navigation in gastric cancer:new horizons for personalized minimally invasive surgical oncology[J].Translational gastroenterology and hepatology,2016,2(1):91.
[15] BARA T J,BARA T,BORZ C,et al. Intraoperative sentinel lymph node mapping with methylene blue dye in gastric cancer[J].European Journal of Surgical Oncology,2016,42(9):S186.
[16] PALLARES-SEGURA J L, BALAGUE-PONS C,DOMINGUEZ-AGUSTIN N,et al. The role of sentinel lymph node in colon cancer evolution[J].Cirugia espanola,2014,92(10):670-675.
[17]范克锋,郝君.腹腔镜结直肠癌根治术中前哨淋巴结定位方法的探讨[J].腹腔镜外科杂志,2014,19(9):673-676.
[18] RAMOS J D S,ALUSTIZA J E,CERMEO TORAL B,et al.Sentinel lymph node in colon cancer:Results in 240 patients[J].Colorectal Disease,2014,10(16):85-86.
[19] SAHA S,JOHNSTON G,KORANT A,et al. Patterns of recurrence and nodal staging in rectal cancer patients undergoing sentinel node mapping in rectal cancer and the difference compared to conventional surgery regarding nodal metastasis and recurrence[J].Diseases of the Colon and Rectum,2014,57(5):e348-e349.
[20] GOSPODAROWICZ M K,BRIERLEY J D,WITTEKIND C. TNM classification of malignant tumours[M].Hoboken:John Wiley&Sons,2017:65-75.
[21] MA..RKL B,KERWEL T G,WAGNER T,et al. Methylene blue injection into the rectal artery as a simple method to improve lymph node harvest in rectal cancer[J].Modern Pathology,2007,20(7):797-801.
[22] LANGMAN G,PATEL A,BOWLEY D M. Size and distribution of lymph nodes in rectal cancer resection specimens[J].Dis Colon Rectum,2015,58(4):406-414.
[23] PARK J S,CHANG I T,PARK S J,et al. Comparison of ex vivo and in vivo injection of blue dye in sentinel lymph node mapping for colorectal cancer[J].World J Surg,2009,33(3):539-546.
[24]叶春华,龚铁逢,邓崇文,等.胃癌前哨淋巴结定位及活检技术探讨[J].中外医学研究,2015,13(26):21-22.
[25] MARKL B,ARNHOLDT H. Lymph node staging in gastrointestinal cancer. Combination of methylene blue-assisted lymph node dissection and ex vivo sentinel lymph node mapping[J].Der Pathologe,2012,33(Suppl 2):325-330.
[26] AOYAMA T,FUJIKAWA H,CHO H,et al. A methylene blue-assisted technique for harvesting lymph nodes after radical surgery for gastric cancer a prospective,randomized,controlled study[J].American Journal of Surgical Pathology,2015,39(2):266-273.
[27]王鹏鹏.胃癌淋巴结检出数目的影响因素分析及检出方法的探索[J].中华外科杂志,2017,55(4):255-259.
[28] MOHAN B. Intra operative sentinel lymph node positivity by methylene blue dye and its association with other dissected lymph node by histopathological examination in colorectal cancer[J].European Journal of Cancer,2017,72(1):S57.
[29] BARA T,JR.,GURZU S,JUNG I,KADAR Z,et al. Single skip metastasis in sentinel lymph node:In an early gastric cancer[J].World J Gastroenterol,2015,21(33):9803-9807.
[30] LOPEZ-DE L A,MANZANARA CANO C,CORDERO GARCIA J M,et al. Sentinel lymph node detection using99mTc combined with methylene blue cervical injection for endometrial cancer surgical management:a prospective study[J].International Journal of Gynecological Cancer:Official Journal of the International Gynecological Cancer Society,2014,24(6):1048-1053.
[31]洪斌,沈学远,陈江勇.联合亚甲蓝和99m Tc-硫胶体核素示踪法在早期非小细胞肺癌前哨淋巴结定位中的应用[J].南方医科大学学报,2014,34(7):1053-1056.
[32] TUMMERS Q R,SCHEPERS A,HAMMING J F,et al.Intraoperative guidance in parathyroid surgery using near-infrared fluorescence imaging and low-dose Methylene Blue[J].Surgery,2015,158(5):1323-1330.
[33] TUMMERS Q R,VERBEEK F P,SCHAAFSMA B E,et al. Real-time intraoperative detection of breast cancer using near-infrared fluorescence imaging and Methylene Blue[J].European Journal of Surgical Oncology:the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology,2014,40(7):850-858.
[2] CHEN W,ZHENG R,BAADE P D,et al. Cancer statistics in China,2015[J].CA:A Cancer Journal for Clinicians,2016,66(2):115-132.
[3] REIMA H,SAAR H,INNOS K,et al. Methylene blue intra-arterial staining of resected colorectal cancer specimens improves accuracy of nodal staging:A randomized controlled trial[J].Ejso,2016,42(11):1642-1646.
[4] FAROUK A,RASHAD R. Improved detection of lymph nodes in cases of rectal cancer using combined methylene blue injection and fat clearance compared with fat clearance alone[J].Egyptian Journal of Surgery,2017,36(4):340-345.
[5] JEPSEN R K,INGEHOLM P,LUND E L. Upstaging of early colorectal cancers following improved lymph node yield after methylene blue injection[J].Histopathology,2012,61(5):788-794.
[6] CABANAS R M. An approach for the treatment of penile carcinoma[J].Cancer,1977,39(2):456-466.
[7] LIU J,HUANG P,ZHENG Z,et al. Modified methylene blue injection improves lymph node harvest in rectal cancer[J].Anz Journal of Surgery,2017,87(4):247-251.
[8] MARTIN-LAZARO J,NUNEZ-ORJALES R,BATTIKHIPRECEDO N,et al. Allergy to blue dye[J].Journal of investigational allergology&clinical immunology,2016,26(6):381-383.
[9]吴殿文,王锡山.结直肠癌前哨淋巴结活检的临床意义[J].中华结直肠疾病电子杂志,2014,3(4):288-291.
[10] MOCELLIN S,MCCULLOCH P,KAZI H,et al. Extent of lymph node dissection for adenocarcinoma of the stomach[J].The Cochrane database of systematic reviews,2015,12(8):Cd001964.
[11] MOCELLIN S,NITTI D. Lymphadenectomy extent and survival of patients with gastric carcinoma:a systematic review and meta-analysis of time-to-event data from randomized trials[J].Cancer treatment reviews,2015,41(5):448-454.
[12]柯孔亮,戴永平,郭宇,等.亚甲蓝示踪技术在胃癌前哨淋巴结活检中的应用[J].现代实用医学,2015,27(5):623-625.
[13]吴凯,刘伟,冯旭刚,马龙安.前哨淋巴结定位检测在早期诊断进展期胃癌中的作用分析[J].海南医学院学报,2015,21(6):805-807.
[14] LIANOS G D,HASEMAKI N,VAGGELIS G,et al. Sentinel node navigation in gastric cancer:new horizons for personalized minimally invasive surgical oncology[J].Translational gastroenterology and hepatology,2016,2(1):91.
[15] BARA T J,BARA T,BORZ C,et al. Intraoperative sentinel lymph node mapping with methylene blue dye in gastric cancer[J].European Journal of Surgical Oncology,2016,42(9):S186.
[16] PALLARES-SEGURA J L, BALAGUE-PONS C,DOMINGUEZ-AGUSTIN N,et al. The role of sentinel lymph node in colon cancer evolution[J].Cirugia espanola,2014,92(10):670-675.
[17]范克锋,郝君.腹腔镜结直肠癌根治术中前哨淋巴结定位方法的探讨[J].腹腔镜外科杂志,2014,19(9):673-676.
[18] RAMOS J D S,ALUSTIZA J E,CERMEO TORAL B,et al.Sentinel lymph node in colon cancer:Results in 240 patients[J].Colorectal Disease,2014,10(16):85-86.
[19] SAHA S,JOHNSTON G,KORANT A,et al. Patterns of recurrence and nodal staging in rectal cancer patients undergoing sentinel node mapping in rectal cancer and the difference compared to conventional surgery regarding nodal metastasis and recurrence[J].Diseases of the Colon and Rectum,2014,57(5):e348-e349.
[20] GOSPODAROWICZ M K,BRIERLEY J D,WITTEKIND C. TNM classification of malignant tumours[M].Hoboken:John Wiley&Sons,2017:65-75.
[21] MA..RKL B,KERWEL T G,WAGNER T,et al. Methylene blue injection into the rectal artery as a simple method to improve lymph node harvest in rectal cancer[J].Modern Pathology,2007,20(7):797-801.
[22] LANGMAN G,PATEL A,BOWLEY D M. Size and distribution of lymph nodes in rectal cancer resection specimens[J].Dis Colon Rectum,2015,58(4):406-414.
[23] PARK J S,CHANG I T,PARK S J,et al. Comparison of ex vivo and in vivo injection of blue dye in sentinel lymph node mapping for colorectal cancer[J].World J Surg,2009,33(3):539-546.
[24]叶春华,龚铁逢,邓崇文,等.胃癌前哨淋巴结定位及活检技术探讨[J].中外医学研究,2015,13(26):21-22.
[25] MARKL B,ARNHOLDT H. Lymph node staging in gastrointestinal cancer. Combination of methylene blue-assisted lymph node dissection and ex vivo sentinel lymph node mapping[J].Der Pathologe,2012,33(Suppl 2):325-330.
[26] AOYAMA T,FUJIKAWA H,CHO H,et al. A methylene blue-assisted technique for harvesting lymph nodes after radical surgery for gastric cancer a prospective,randomized,controlled study[J].American Journal of Surgical Pathology,2015,39(2):266-273.
[27]王鹏鹏.胃癌淋巴结检出数目的影响因素分析及检出方法的探索[J].中华外科杂志,2017,55(4):255-259.
[28] MOHAN B. Intra operative sentinel lymph node positivity by methylene blue dye and its association with other dissected lymph node by histopathological examination in colorectal cancer[J].European Journal of Cancer,2017,72(1):S57.
[29] BARA T,JR.,GURZU S,JUNG I,KADAR Z,et al. Single skip metastasis in sentinel lymph node:In an early gastric cancer[J].World J Gastroenterol,2015,21(33):9803-9807.
[30] LOPEZ-DE L A,MANZANARA CANO C,CORDERO GARCIA J M,et al. Sentinel lymph node detection using99mTc combined with methylene blue cervical injection for endometrial cancer surgical management:a prospective study[J].International Journal of Gynecological Cancer:Official Journal of the International Gynecological Cancer Society,2014,24(6):1048-1053.
[31]洪斌,沈学远,陈江勇.联合亚甲蓝和99m Tc-硫胶体核素示踪法在早期非小细胞肺癌前哨淋巴结定位中的应用[J].南方医科大学学报,2014,34(7):1053-1056.
[32] TUMMERS Q R,SCHEPERS A,HAMMING J F,et al.Intraoperative guidance in parathyroid surgery using near-infrared fluorescence imaging and low-dose Methylene Blue[J].Surgery,2015,158(5):1323-1330.
[33] TUMMERS Q R,VERBEEK F P,SCHAAFSMA B E,et al. Real-time intraoperative detection of breast cancer using near-infrared fluorescence imaging and Methylene Blue[J].European Journal of Surgical Oncology:the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology,2014,40(7):850-858.