本文選題：顯像劑 + 吲哚菁綠　； 參考：《濟(jì)南大學(xué)》2017年碩士論文

【摘要】：背景與目的:前哨淋巴結(jié)(Sentinel Lymph Node,SLN)活檢已成為臨床腋淋巴結(jié)陰性早期乳腺癌病人的標(biāo)準(zhǔn)處理模式,并對(duì)乳腺癌的分期和治療方案的選擇至關(guān)重要。該研究將吲哚菁綠(Indocyanine Green,ICG)和利妥昔單抗(Rituximab)進(jìn)行偶聯(lián)作為新型示蹤劑,采用小鼠后肢SLN動(dòng)物模型,模擬乳腺癌SLN活檢術(shù),探索其SLN的定位效應(yīng)。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(yīng)用熒光脈管系統(tǒng)成像儀連續(xù)觀測(cè)乆窩淋巴結(jié)(SLN)至開(kāi)始顯像,后每隔5min觀察一次持續(xù)至3h,記錄SLN開(kāi)始出現(xiàn)熒光顯像的時(shí)間以及達(dá)到最佳顯像效果所需的時(shí)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(lán)染料),解剖SLN及后續(xù)引流淋巴結(jié),應(yīng)用熒光脈管系統(tǒng)成像儀測(cè)量有無(wú)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(lán)染料),解剖SLN及后續(xù)引流淋巴結(jié),應(yīng)用熒光脈管系統(tǒng)成像儀測(cè)量有無(wú)熒光顯像。結(jié)果:定義乆窩淋巴結(jié)為小鼠后肢淋巴引流的SLN,髂淋巴結(jié)為次級(jí)淋巴結(jié),主動(dòng)脈旁或腎旁淋巴結(jié)為第三級(jí)淋巴結(jié)(個(gè)別小鼠主動(dòng)脈旁淋巴結(jié)缺如,此時(shí)選取腎旁淋巴結(jié)為第三級(jí)淋巴結(jié))。隨著注射劑量的增加,SLN開(kāi)始顯像的時(shí)間與達(dá)到最佳顯像效果所需的時(shí)間均逐漸縮短,次級(jí)及第三級(jí)淋巴結(jié)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(dá)到最佳顯像效果的時(shí)間約為34min。觀察至24h,SLN顯像率維持在100%,次級(jí)及第三級(jí)淋巴結(jié)顯像率由6h的0%和0%上升至24h的20%和10%。結(jié)論:本研究建立的小鼠后肢SLN動(dòng)物模型設(shè)置簡(jiǎn)單,成本低,淋巴系統(tǒng)發(fā)達(dá)可以清晰揭示示蹤劑在淋巴管和淋巴結(jié)中的引流情況。在小鼠SLN動(dòng)物模型中ICGRituximab的最佳注射劑量為0.12μg(ICG的量),SLN活檢時(shí)最佳的SLN顯像時(shí)間窗為注射后34分鐘至6小時(shí),即能清晰定位SLN又無(wú)次級(jí)淋巴結(jié)顯像,具有較高的臨床應(yīng)用價(jià)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(xué)位授予單位】：濟(jì)南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.9;R-332

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本文編號(hào)：2100430