本文選題：顯像劑 + 吲哚菁綠　； 參考：《濟南大學》2017年碩士論文

【摘要】：背景與目的:前哨淋巴結(Sentinel Lymph Node,SLN)活檢已成為臨床腋淋巴結陰性早期乳腺癌病人的標準處理模式,并對乳腺癌的分期和治療方案的選擇至關重要。該研究將吲哚菁綠(Indocyanine Green,ICG)和利妥昔單抗(Rituximab)進行偶聯(lián)作為新型示蹤劑,采用小鼠后肢SLN動物模型,模擬乳腺癌SLN活檢術,探索其SLN的定位效應。方法:首先建立小鼠后肢淋巴引流模型。(1)Balb/c小鼠后肢腳背皮下注射不同劑量(0.48μg、0.24μg、0.12μg、0.06μg)的ICG-Rituximab,并應用熒光脈管系統(tǒng)成像儀連續(xù)觀測乆窩淋巴結(SLN)至開始顯像,后每隔5min觀察一次持續(xù)至3h,記錄SLN開始出現(xiàn)熒光顯像的時間以及達到最佳顯像效果所需的時間。3h脫頸椎處死小鼠(處死前5min于小鼠后肢腳背皮下相同位置注射亞甲藍染料),解剖SLN及后續(xù)引流淋巴結,應用熒光脈管系統(tǒng)成像儀測量有無熒光顯像,確定示蹤劑的最佳注射劑量;(2)最佳注射劑量的ICG-Rituximab(0.12μg,ICG的含量)注射于小鼠后肢腳背皮下后分別于6h、12h、24h脫頸椎處死小鼠(處死前5min以相同方式注射亞甲藍染料),解剖SLN及后續(xù)引流淋巴結,應用熒光脈管系統(tǒng)成像儀測量有無熒光顯像。結果:定義乆窩淋巴結為小鼠后肢淋巴引流的SLN,髂淋巴結為次級淋巴結,主動脈旁或腎旁淋巴結為第三級淋巴結(個別小鼠主動脈旁淋巴結缺如,此時選取腎旁淋巴結為第三級淋巴結)。隨著注射劑量的增加,SLN開始顯像的時間與達到最佳顯像效果所需的時間均逐漸縮短,次級及第三級淋巴結顯像率逐漸升高。新型示蹤劑的最佳注射劑量為0.12μg(ICG的含量),達到最佳顯像效果的時間約為34min。觀察至24h,SLN顯像率維持在100%,次級及第三級淋巴結顯像率由6h的0%和0%上升至24h的20%和10%。結論:本研究建立的小鼠后肢SLN動物模型設置簡單,成本低,淋巴系統(tǒng)發(fā)達可以清晰揭示示蹤劑在淋巴管和淋巴結中的引流情況。在小鼠SLN動物模型中ICGRituximab的最佳注射劑量為0.12μg(ICG的量),SLN活檢時最佳的SLN顯像時間窗為注射后34分鐘至6小時,即能清晰定位SLN又無次級淋巴結顯像,具有較高的臨床應用價值。
[Abstract]:Background & objective: Sentinel Lymph NodeSLN biopsy has become the standard management model for early breast cancer patients with negative axillary lymph nodes, and is very important to the stage and treatment of breast cancer. In this study, indocyanine green (ICG) and Rituximab (Rituximab) were coupled as a new tracer. SLN animal model of mouse hind limb was used to simulate SLN biopsy of breast cancer to explore the localization effect of SLN. Methods: the lymphatic drainage model of the hind limb was established. (1) Balb / c mice were subcutaneously injected with different doses (0.48 渭 g / 0. 24 渭 g / g) of ICG-Rituximab. and the fluorescent vascular system was used to observe the lymph nodes (SLN) until the beginning of the imaging. After the 5min was observed every 3 hours, the time when the fluorescence imaging began to appear and the time required to achieve the best imaging effect were recorded. The mice were killed by removing the cervical vertebrae for 3 hours. (5min was injected in the same subcutaneous position on the back of the hind limbs of the mice before execution. Methylene blue dye), anatomic SLN and subsequent drainage lymph nodes, The fluorescence imaging system was used to measure the fluorescence imaging. The optimal dose of tracer was determined; (2) the optimal dose of ICG-Rituximab (0.12 渭 g ICG) was injected into the lower extremity of mice subcutaneously, and the mice were killed at 6h, 12h and 24h, respectively (5min was injected with methylene blue dye in the same way before execution). Subsequent drainage of lymph nodes, Fluorescence imaging system was used to measure fluorescence imaging. Results: the lymph nodes were defined as SLNs, iliac lymph nodes as secondary lymph nodes and para-aortic or para-renal lymph nodes as tertiary lymph nodes. The parrenal lymph nodes were selected as the third stage lymph nodes. With the increase of injection dose, the start time of SLN and the time needed to achieve the best imaging effect were shortened, and the secondary and tertiary lymph node imaging rates increased gradually. The optimal injection dose of the new tracer was 0.12 渭 g (ICG content), and the best imaging time was about 34 min. The SLN imaging rate at 24 h was maintained at 100 and the secondary and tertiary lymph node imaging rates increased from 0% and 0% at 6 h to 20% and 10% at 24 h. Conclusion: the SLN animal model of mouse hind limb established in this study has the advantages of simple setting and low cost. The developed lymphatic system can clearly reveal the drainage of tracer in lymphatic vessels and lymph nodes. The optimal injection dose of ICGRituximab in mouse SLN model was 0.12 渭 g (ICG). The best SLN imaging time window for SLN biopsy was 34 minutes to 6 hours after injection, which could locate SLN clearly without secondary lymph node imaging.
【學位授予單位】：濟南大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.9;R-332

【參考文獻】

相關期刊論文 前3條

1 王永勝;歐陽濤;王啟堂;蘇逢錫;朱時光;吳炅;尉承澤;王水;曹蘇生;李濟宇;;中國前哨淋巴結活檢多中心協(xié)作研究CBCSG-001最新資料報告[J];中華乳腺病雜志(電子版);2009年03期

2 王永勝;;乳腺癌前哨淋巴結活檢的安全性[J];中國癌癥雜志;2006年09期

3 王雪鵑;王榮福;楊志;林保和;徐冰;張巖;張梅穎;;前哨淋巴結示蹤劑~(99)Tc~m-IT-Rituximab的制備及初步動物實驗研究[J];中國醫(yī)學影像技術;2006年01期

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