口腔疾病防治 ›› 2020, Vol. 28 ›› Issue (2): 118-122.DOI: 10.12016/j.issn.2096-1456.2020.02.011

• 综述 • 上一篇    下一篇

吲哚菁绿在口腔癌可视化治疗中的应用

张誉,季彤()   

  1. 上海交通大学医学院附属第九人民医院·口腔医学院口腔头颈肿瘤科,上海(200011)
  • 收稿日期:2018-12-08 修回日期:2019-10-09 出版日期:2020-02-20 发布日期:2020-02-25
  • 通讯作者: 季彤
  • 作者简介:张誉,住院医师,硕士研究生,Email: 464325024@qq.com
  • 基金资助:
    国家自然科学基金项目(81671009)

Application of Indocyanine green in visual treatment of oral cancer

ZHANG Yu,JI Tong()   

  1. Department of Oral & Maxillofacial-Head & Neck Oncology, Shanghai Ninth People′s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Received:2018-12-08 Revised:2019-10-09 Online:2020-02-20 Published:2020-02-25
  • Contact: Tong JI

摘要:

吲哚菁绿(indocyanine green, ICG)是一种荧光显影剂,有低创伤、高时效、低细胞毒性、高显像分辨率等特点,已被广泛用于生物医学领域中。但ICG在口腔癌治疗中的应用并不多,本文就ICG在口腔癌诊治中的应用进行综述。文献复习结果表明,在口腔癌的诊治中,ICG主要通过荧光物质高通透性和滞留效应(enhanced permeability and retention effect, EPR)及偶联各种肿瘤特异性抗体发挥作用。在肿瘤可视化方面,ICG通过偶联特异性肿瘤抗体及EPR效应聚集于肿瘤原发灶及淋巴转移灶,从而指导肿瘤原发灶的完整切除及颈淋巴清扫的选择。在口腔头颈修复重建方面,通过对ICG荧光强度的半定量测定,在术中指导游离血管化皮瓣的设计,在术后及早发现皮瓣危象,指导临床皮瓣探查的时机。在口腔癌的非手术治疗如光热治疗、光动力治疗中,ICG作为光敏纳米材料中的重要组成部分也吸引了众多学者的研究。ICG在口腔癌的切除,修复重建可视化及非手术治疗中均有良好的应用前景。

关键词: 吲哚菁绿, 口腔癌, 肿瘤可视化, 游离皮瓣, 修复重建, 荧光显影, 光动力治疗, 综合序列治疗

Abstract:

Indocyanine green (ICG) is a fluorescence indicator characterized by low trauma, a long effect time, low cytotoxicity, and high imaging resolution. It has been widely used in biomedical applications. However, ICG is not widely used in the treatment of oral cancer. This article reviews the application of ICG in the diagnosis and treatment of oral cancer. The results of a literature review showed that in the diagnosis and treatment of oral cancer, ICG mainly plays a role through the enhanced permeability and retention (EPR) effect of fluorescent substances and in coupling with various tumor-specific antibodies. For tumor visualization, ICG can focus on the primary tumor and lymph node metastasis by coupling the specific tumor antibodies and the EPR effect to guide the complete resection of the primary tumor and the determination of neck lymphadenectomy. In the reconstruction of the oral, head and neck regions, semi-quantitative measurement of ICG fluorescence intensity can be used to design a guide for a vascularized flap during the operation, for early detection of flap crisis after the operation, and to guide clinical flap exploration opportunities. In nonsurgical treatments of oral cancer, such as photothermal therapy and photodynamic therapy, ICG, as an important component of photosensitive nanomaterials, has attracted the attention of many scholars. ICG has good application prospects in the resection, reconstruction, visualization and nonsurgical treatment of oral cancer.

Key words: indocyanine green, oral cancer, tumor visualization, free vascularized flap, reconstruction, fluorography, photodynamic therapy, sequential combined treatment

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