Diagnostic value of endoscopic ultrasound versus indocyanine green fluorescence imaging for sentinel and lymph node metastasis in patients with colorectal cancer.

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Journal of gastrointestinal oncology Pub Date : 2025-08-30 Epub Date: 2025-08-27 DOI:10.21037/jgo-2024-917
Guocong Wu, Yu Huang, Meifeng He, Chenggang Ren, Zhuo Wang, Yangyang Liu, Yao Zhang, Jianyong He, Shaoshuai Liu, Zhengeng Jia
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引用次数: 0

Abstract

Background: Sentinel lymph nodes and lymph node metastases in patients with colorectal cancer (CRC) seriously affect prognosis. In order to improve the accuracy of lymph node assessment during surgery, it is crucial to explore advanced imaging techniques. This study aimed to evaluate the diagnostic value of endoscopic ultrasound (EUS) versus indocyanine green (ICG) fluorescence imaging for sentinel lymph node metastasis (SLNM) and lymph node metastasis (LNM) in patients with CRC.

Methods: A total of 120 patients with CRC admitted to our hospital from March 2022 to December 2023 were included in this retrospective study and, according to the detection method, they were divided into ICG group (ICG fluorescence imaging group, n=50) and control group (EUS group, n=70). The general data of patients, sensitivity, specificity, and accuracy of ICG imaging for the diagnosis of SLNM and LNM in patients with CRC were statistically compared between the two groups using gold standard postoperative pathology reports. Area under receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of ICG fluorescence imaging for SLNM and LNM in patients with CRC.

Results: For diagnosing SLNM in CRC patients, ICG fluorescence imaging achieved sensitivities, specificities, and accuracies of 94.44%, 93.75%, and 94.00%, respectively, significantly outperforming EUS, which achieved sensitivities, specificities, and accuracies of 40.74%, 69.77%, and 58.58% respectively. For LNM diagnosis, ICG fluorescence imaging showed sensitivities, specificities, and accuracies of 80.00%, 92.5%, and 90.00%, compared to 28.57%, 71.43%, and 62.86% for EUS. The area under curve (AUC) of ICG for LNM in patients with CRC was 0.932 with an optimal cut-off value of 0.77, achieving sensitivities and specificities of 95.45% and 81.82%.

Conclusions: In the assessment of SLNM and LNM in patients with CRC, ICG fluorescence imaging is proven to be more valuable than EUS.

Abstract Image

内镜超声与吲哚菁绿荧光对结直肠癌前哨及淋巴结转移的诊断价值。
背景:结直肠癌(CRC)患者前哨淋巴结和淋巴结转移严重影响预后。为了提高手术中淋巴结评估的准确性,探索先进的影像学技术至关重要。本研究旨在评价内镜超声(EUS)与吲哚菁绿(ICG)荧光成像对结直肠癌前哨淋巴结转移(SLNM)和淋巴结转移(LNM)的诊断价值。方法:回顾性研究2022年3月至2023年12月我院收治的120例结直肠癌患者,根据检测方法分为ICG组(ICG荧光显像组,n=50)和对照组(EUS组,n=70)。采用金标准术后病理报告,对两组患者的一般资料、ICG成像诊断结直肠癌患者SLNM和LNM的敏感性、特异性和准确性进行统计学比较。采用受试者工作特征曲线下面积(Area under receiver operating characteristic, ROC)分析ICG荧光成像对结直肠癌患者SLNM和LNM的诊断价值。结果:ICG荧光成像诊断结直肠癌患者SLNM的灵敏度、特异性和准确性分别为94.44%、93.75%和94.00%,明显优于EUS的灵敏度、特异性和准确性分别为40.74%、69.77%和58.58%。对于LNM诊断,ICG荧光成像的敏感性、特异性和准确性分别为80.00%、92.5%和90.00%,而EUS的敏感性、特异性和准确性分别为28.57%、71.43%和62.86%。ICG诊断结直肠癌患者LNM的曲线下面积(AUC)为0.932,最佳临界值为0.77,敏感性和特异性分别为95.45%和81.82%。结论:在评估结直肠癌患者的SLNM和LNM时,ICG荧光成像比EUS更有价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
171
期刊介绍: ournal of Gastrointestinal Oncology (Print ISSN 2078-6891; Online ISSN 2219-679X; J Gastrointest Oncol; JGO), the official journal of Society for Gastrointestinal Oncology (SGO), is an open-access, international peer-reviewed journal. It is published quarterly (Sep. 2010- Dec. 2013), bimonthly (Feb. 2014 -) and openly distributed worldwide. JGO publishes manuscripts that focus on updated and practical information about diagnosis, prevention and clinical investigations of gastrointestinal cancer treatment. Specific areas of interest include, but not limited to, multimodality therapy, markers, imaging and tumor biology.
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