EFFECT OF INDOCYANINE GREEN (ICG)-MEDIATED NEAR-INFRARED LIGHT GUIDED LIVER TUMOR RESECTION ON THE PROGNOSIS OF PATIENTS WITH PRIMARY LIVER CANCER

Wei Feng^{1, 2, *}, Qile Wang^{1, 2}, Sheng Wang^{1, 2}, Zheng Chen^{1, 2}, Bin Lin^{1, 2}

¹Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu Proince, China - ²Department of Hepatobiliary and Pancreatic Surgery, Suqian People’s Hospital of Nanjing Drum Tower Hospital Group, Suqian 223800, Jiangsu Proince, China

Objective: To evaluate the effect of indocyanine green (ICG)-mediated near-infrared-light-guided liver tumor resection on the prognosis of patients with primary liver cancer. 

Methods: 44 patients with primary liver cancer receiving treatment in our hospital from January 2018 to August 2019 were gathered and treated with a transabdominal ultrasound and ICG. The detection rate of residual liver tumors, the detection rate of differently sized tumor focuses, the accuracy rate of distinguishing benign and malignant tumors, and the diagnostic efficiency of the two detection technologies were compared and the influence of ICG-detection technology on the prognosis of patients with primary liver cancer were analyzed. 

Results: there were 12 lesions (0-2.7 cm away from the liver surface) detected by ICG, and the detection rate was 100%. Three lesions (0.7-2.7 cm from the liver surface) were detected by a transabdominal ultrasound before operation, and the detection rate was 33.33%. There was a significant difference between the two techniques in the detection rate of residual liver tumors in vivo (P<0.05). The detection rate of ICG was significantly higher than that of the preoperative transabdominal ultrasound (P<0.05). There was no significant difference in tumor detection rates between the 2 detection techniques for tumor diameter >2 cm (P>0.05). The accuracy of ICG was significantly higher than that of the preoperative transabdominal ultrasound (P<0.05). The sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of the preoperative transabdominal ultrasound were 86.51%, 28.11%, 65.31%, 28.11%, and 68.01%, respectively. The sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of ICG were 96.51%, 84.71%, 94.31%, 84.71%, and 96.51%, respectively. The diagnostic efficiency of ICG was better. No patients died during the 1-year follow-up, and 9.19% (4 of 44) of the patients experience varying degrees of recurrence at 4 months, 8 months, 8 months, and 12 months, respectively. The average recurrence time was 8 months. There were 3 single cases and 1 double cases. 

Conclusion: ICG-mediated near-infrared light detection can better detect tumor lesions and increase the detection rate of missed lesions, which is conducive to improving the effect of liver-tumor resection and reducing the risk of recurrence.