近红外显影技术在前列腺癌淋巴组织显影及病理评估中的应用

doi:10.3877/cma.j.issn.1674-3253.2026.01.002

中华腔镜泌尿外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (01) : 8 -14. doi: 10.3877/cma.j.issn.1674-3253.2026.01.002

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近红外显影技术在前列腺癌淋巴组织显影及病理评估中的应用

蒋钟吉¹^,², 郭洪³, 王东文²^,^†(

)

¹518055　深圳，南方科技大学医学院
²518116　深圳，国家癌症中心/国家肿瘤临床医学研究中心，中国医学科学院肿瘤医院深圳医院泌尿外科
³030001　太原，山西医科大学第一医院泌尿外科

收稿日期:2025-09-30 出版日期:2026-02-01
通信作者: 王东文
基金资助:
国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院肿瘤医院深圳医院重点项目(SZ2020ZD003); 深圳市"三名工程"医学项目(SZSM202111003)

Application of near-infrared imaging technology in lymphatic mapping and pathological evaluation of prostate cancer

Zhongji Jiang¹^,², Hong Guo³, Dongwen Wang²^,^†()

¹School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China
²Department of Urology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen 518116, China
³Department of Urology, First Hospital of Shanxi Medical University, Taiyuan 030001, China

Received:2025-09-30 Published:2026-02-01
Corresponding author: Dongwen Wang

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引用本文：

蒋钟吉, 郭洪, 王东文. 近红外显影技术在前列腺癌淋巴组织显影及病理评估中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2026, 20(01): 8-14.

Zhongji Jiang, Hong Guo, Dongwen Wang. Application of near-infrared imaging technology in lymphatic mapping and pathological evaluation of prostate cancer[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(01): 8-14.

前列腺癌是全球男性最常见的恶性肿瘤之一，精准评估淋巴结状态和优化手术范围对于改善患者预后至关重要。传统影像学技术在实时引导和微转移病灶检测中灵敏性有限，限制了其在临床中的应用。近红外（NIR）荧光成像技术具有无创性、高灵敏度、深组织穿透性和实时成像等优势，能够显著提升前列腺癌淋巴组织显影及病理诊断的效率。非特异性显影剂如吲哚菁绿（ICG）已在临床广泛应用，但缺乏肿瘤特异性。以前列腺特异性膜抗原（PSMA）为靶标的近红外探针能精准识别癌性淋巴结和微转移病灶，具有术中导航及个体化治疗潜力。这种新兴的靶向与近红外II区（NIR-II）成像技术结合的方法，在实现特异性的基础上更突破了近红外I区（NIR-I）在穿透深度和信噪比方面的限制。结合人工智能（AI）辅助病理分析，有望进一步提高微小病灶识别率，推动前列腺癌精准医疗的发展。

关键词: 前列腺癌, 淋巴结转移, 前列腺特异性膜抗原, 近红外荧光成像, 病理, 精准医学

Prostate cancer is one of the most common malignancies among males worldwide. Accurate assessment of lymph node status and optimization of surgical scope are essential for improving patient outcomes. Traditional imaging technologies lack the sensitivity for real-time guidance and micrometastasis detection. Near infrared (NIR) fluorescence imaging provides advantages such as non-invasiveness, high sensitivity, deep tissue penetration, and real-time visualization, which can significantly enhance the efficiency of lymphatic tissue imaging and pathological diagnosis in prostate cancer. While non-specific dyes like indocyanine green (ICG) are widely used, but lack tumor specificity. NIR probes targeting prostate-specific membrane antigen (PSMA) can accurately detect cancerous lymph nodes and micrometastases, supporting surgical navigation and personalized therapy. This emerging approach that integrates targeted strategies with NIR-II imaging not only ensures specificity but also overcomes the limitations of NIR-I in tissue penetration depth and signal-to-noise ratio. When combined with artificial intelligence (AI)-assisted pathological analysis, these advances may enhance the detection of small metastatic lesions and facilitate precision medicine in prostate cancer.

Key words: Prostate cancer, Lymph node metastasis, Prostate-specific membrane antigen (PSMA), Near infrared fluorescence imaging, Pathology, Precision medicine

表1 不同分子探针性能对比

分子探针类型	穿透深度	信噪比	特异性	临床应用现状	主要优势	局限性
吲哚菁绿^[16]	5~10 mm	中等	无	已广泛应用于多种手术导航	成本低，安全性好	缺乏肿瘤特异性，易误判
其他非特异性显影剂(亚甲蓝、纳米碳等)^[17,18]	5~10 mm	低、中等	无	部分在临床应用，已商品化	操作简便	显影持久性差，分辨率有限
靶向探针(近红外-Ⅰ区)^[19]	5~10 mm	中等	高	临床试验阶段（如OTL78等）	高特异性	成本高，安全性与敏感性需进一步验证
靶向探针(近红外-Ⅱ区)^[20]	>1 cm	高	高(可设计)	临床前研究和小样本探索	特异性高，穿透深度大，分辨率高，可识别微转移	设备昂贵，缺乏大规模临床验证

表1 不同分子探针性能对比

分子探针类型	穿透深度	信噪比	特异性	临床应用现状	主要优势	局限性
吲哚菁绿^[16]	5~10 mm	中等	无	已广泛应用于多种手术导航	成本低，安全性好	缺乏肿瘤特异性，易误判
其他非特异性显影剂(亚甲蓝、纳米碳等)^[17,18]	5~10 mm	低、中等	无	部分在临床应用，已商品化	操作简便	显影持久性差，分辨率有限
靶向探针(近红外-Ⅰ区)^[19]	5~10 mm	中等	高	临床试验阶段（如OTL78等）	高特异性	成本高，安全性与敏感性需进一步验证
靶向探针(近红外-Ⅱ区)^[20]	>1 cm	高	高(可设计)	临床前研究和小样本探索	特异性高，穿透深度大，分辨率高，可识别微转移	设备昂贵，缺乏大规模临床验证

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Application of near-infrared imaging technology in lymphatic mapping and pathological evaluation of prostate cancer

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Application of near-infrared imaging technology in lymphatic mapping and pathological evaluation of prostate cancer