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中华乳腺病杂志(电子版) ›› 2026, Vol. 20 ›› Issue (03) : 174 -178. doi: 10.3877/cma.j.issn.1674-0807.2026.03.007

综述

吲哚菁绿在乳腺癌外科诊疗中的应用
宁海洋, 武春慧, 刘妍, 许慧娟, 高婷婷, 李炘正()   
  1. 030001 太原,山西医科大学第二临床医学院/山西医科大学第二医院乳腺外科
  • 收稿日期:2025-12-16 出版日期:2026-06-01
  • 通信作者: 李炘正
  • 基金资助:
    北京中康联公益基金会科研计划重大课题项目(ZKL-KY-ZXGJ-2025092003)

Indocyanine green in diagnosis and treatment of breast cancer surgery

Haiyang Ning, Chunhui Wu, Yan Liu   

  • Received:2025-12-16 Published:2026-06-01
引用本文:

宁海洋, 武春慧, 刘妍, 许慧娟, 高婷婷, 李炘正. 吲哚菁绿在乳腺癌外科诊疗中的应用[J/OL]. 中华乳腺病杂志(电子版), 2026, 20(03): 174-178.

Haiyang Ning, Chunhui Wu, Yan Liu. Indocyanine green in diagnosis and treatment of breast cancer surgery[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2026, 20(03): 174-178.

吲哚菁绿近红外荧光成像技术将荧光信号转化为视觉信息,为手术医师提供可视化导航,已广泛应用于外科各个领域,其安全性及有效性得到充分验证。本文阐述吲哚菁绿近红外荧光成像技术的核心原理,系统梳理其在乳腺癌外科诊疗中的应用现状,包括前哨淋巴结活检、淋巴水肿预测、保留乳房手术切缘判定、乳房重建皮瓣血运评估及光热治疗等关键领域,分析该技术在临床应用中存在的操作标准不统一、靶向特异性不足、成像深度有限等问题,展望其在靶向探针优化、多模态成像融合等方面的发展方向,为吲哚菁绿在乳腺癌外科诊疗中的规范化应用及后续研究提供参考。

表1 4种示踪剂的优缺点对比
表2 不同引导方式下乳腺癌患者行保乳手术的效果对比
研究者 组别 ICG注射方式 结果
Lee等30 ICG组(114例);超声引导皮肤标记组(300例) 术前超声定位肿瘤,25 mg ICG以10 ml蒸馏水稀释后取0.2 ml多点注射于肿瘤切除面 肿瘤识别率:ICG组100%(114/114),超声组100%(300/300);术中切缘阳性率:ICG组10.5%(12/114)<超声组25.0%(75/300);最终切缘阳性率:ICG组3.5%(4/114)<超声组14.7%(44/300)
Pop等31 ICG组(35例) 麻醉诱导时,静脉注射0.25 mg/kg 手术切缘评估准确率71%(25/35)
许华等32 ICG组(58例);超声导丝定位组(33例) 术前8~12 h,肘静脉注射0.75 mg/kg 2组切缘阳性率、手术时间、切除体积差异无统计学意义(P>0.05);手术切缘距肿瘤边界≤2 mm病例占比:ICG组89.66%(52/58)>超声组69.70%(23/33)
焦伟等33 ICG组(55例);传统手术组a(100例) 术前 2 h,外周静脉注射0.5 mg/kg 首次切缘阳性率:ICG组3.6%(2/55)<传统手术组19.0%(19/100);术后美容效果优良率:ICG组 92.7%(51/55)>传统手术组80.0%(80/100);手术时间:ICG组(13.85±3.39) min<传统手术组(18.78±4.81) min
孙嘉忆等34 ICG组(32例);超声导丝定位组(30例) 麻醉诱导时,超声引导下瘤内注射2.5~10 mg 首次切缘阴性率:ICG组 87.5%(28/32)>超声组 63.3%(19/30);2组切除体积、手术时间差异无统计学意义(P>0.05)
吕刚等35 ICG组(24例);传统手术组a(26例) 术前2~3 h,外周静脉注射0.5 mg/kg 手术切缘距肿瘤边界距离:ICG组(8.36±6.42) mm<传统手术组(15.08±4.75) mm
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