Over the past decade, SLN mapping has become increasingly important in cervical cancer surgery. ICG is the most commonly used tracer due to its high bilateral detection rates, ease of use, and safety. However, there is no consensus on the optimal ICG dose, leading to variability in outcomes. This systematic review aims to evaluate the impact of different ICG doses on SLN detection in early-stage cervical cancer, identifying the most effective and safe dose for clinical practice. A comprehensive search was conducted in MEDLINE/PubMed up to May 2024. Studies included assessed SLN mapping using ICG in stage IA2-IIA/IIB cervical cancer. Exclusions were applied to studies not reporting ICG dose or using multiple tracers without dose-specific results. Twelve studies were included, with ICG concentrations ranging from 0.25 mg/mL to 25 mg/mL and injection volumes from 1 to 10 mL. Overall SLN detection rates ranged from 88% to 100%, while bilateral detection rates varied between 74.1% and 98.5%. The most consistent results were obtained with an ICG concentration of 1.25 mg/mL and a 4 mL injection volume. In conclusion, an ICG concentration of 1.25 mg/mL with a 4 mL injection volume is recommended for effective SLN mapping in cervical cancer, achieving high detection rates with minimal variability. Standardizing this dose in clinical practice is suggested to improve reproducibility and outcomes.
过去十年中，前哨淋巴结（SLN）定位在宫颈癌手术中的重要性日益凸显。吲哚菁绿（ICG）因其双侧检出率高、使用便捷且安全性良好，成为最常用的示踪剂。然而，关于ICG的最佳剂量尚未达成共识，导致临床结果存在差异。本系统综述旨在评估不同ICG剂量对早期宫颈癌SLN检出效果的影响，以确定临床实践中最高效安全的剂量方案。研究检索了截至2024年5月的MEDLINE/PubMed数据库，纳入标准为使用ICG进行SLN定位的IA2-IIA/IIB期宫颈癌研究，排除未报告ICG剂量或使用多种示踪剂但未提供剂量特异性结果的研究。最终纳入12项研究，ICG浓度范围为0.25 mg/mL至25 mg/mL，注射体积为1至10 mL。总体SLN检出率为88%至100%，双侧检出率在74.1%至98.5%之间波动。使用1.25 mg/mL浓度配合4 mL注射体积的方案获得了最稳定的结果。综上所述，建议在宫颈癌SLN定位中采用1.25 mg/mL浓度联合4 mL注射体积的ICG方案，该方案能在保证高检出率的同时最大限度降低结果变异性。临床实践中标准化该剂量方案有助于提升结果可重复性并改善治疗结局。
肿瘤(癌症)患者之家