用青绿偶氮天蓝（isosulfan blue）和吲哚菁绿（indocyanine green，简称ICG）进行静脉注射的白色介导淋巴显像法（Technetium-99（99m Tc）淋巴显像）是肉瘤LYMPHOSIAL的标准方法，但青绿偶氮天蓝已知有副作用，而99m Tc的注射可能增加小儿患者麻醉时间。ICG有助于SLN的可视性和识别，它可以作为辅助方法。我们假设ICG在SLN活检中的敏感性与青绿偶氮天蓝相似。本研究共纳入30名患者（36个手术，共计96个标本），先皮下注射99m Tc，然后皮下注射青绿偶氮天蓝和ICG。青绿偶氮天蓝、ICG和99m Tc的测试特性包括敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。ICG的敏感性为87%，对热淋巴结检测的阳性预测值（PPV）为83%；青绿偶氮天蓝的敏感性为44%，PPV为97%。对于病理证实的淋巴结检测，ICG的敏感性为84%，阳性预测值（PPV）为91%；99m Tc的敏感性为82%，PPV为94%。ICG在与99m Tc（比值比[OR]，0.818；95%置信区间[CI]，0.3-2.172；p = .823）相比，对于病理证实的淋巴结的检测具有相似的可能性，OR比青绿偶氮天蓝更高（OR，0.025；95% CI，0.001-0.148；p < .001）。本研究证实了ICG在儿童和年轻成人群体SLNB中的功效。ICG安全，比青绿偶氮天蓝更有效，并可能避免有选择性患者需要进行淋巴显像术，从而减少麻醉时间。© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

Technetium-99 (99m Tc) lymphoscintigraphy with blue dye injection is an accepted method for sentinel lymph node (SLN) mapping, but blue dye has known adverse effects, and injection of 99m Tc may increase time under anesthesia for pediatric patients. Indocyanine green (ICG) may serve as an adjunct to assist with visibility and identification of SLNs. We hypothesized that sensitivity of ICG was similar to blue dye in SLN biopsies.Thirty patients (36 procedures with 96 total specimens) underwent preoperative intradermal injection of 99m Tc, followed by intradermal injection of isosulfan blue and ICG. Test characteristics of blue dye, ICG, and 99m Tc included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).ICG had a sensitivity of 87% and PPV of 83% for detection of 99m Tc-hot lymph nodes; blue dye had a sensitivity of 44% and PPV of 97%. For detection of pathologically confirmed lymph nodes, ICG had a sensitivity of 84% and a positive predictive value (PPV) of 91%. 99m Tc had a sensitivity of 82% and a PPV of 94%. ICG had no significant difference in odds of being positive in pathology-confirmed lymph nodes compared to 99m Tc (odds ratio [OR], 0.818; 95% confidence interval [CI], 0.3-2.172; p = .823) and had higher odds than isosulfan blue (OR, 0.025, 95% CI, 0.001-0.148; p < .001).This study established the efficacy of ICG as an adjunct to SLNB in the pediatric and young adult population. ICG was safe, more efficacious than blue dye, and may obviate the need for lymphoscintigraphy in selected patients resulting in reduced time under anesthesia.© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.