Application value of indocyanine green fluorescence imaging in guiding sentinel lymph node biopsy diagnosis of gastric cancer: Meta-analysis

Table 1 Basic characteristics of 15 included literature

Ref.	Year	Country	Cases	Average age (years)	Sex (male/female)	CT staging	Average tumor diameter (mm)	ICC concentration (g/L)	Average number of SLN detections	Sensitivity (%)	Specific (%)
Nimura et al[6]	2004	Japan	84	_	_	T1-2	_	5	10.5	100	59.7
Ishikawa et al[7]	2007	Japan	16	57.0	8/8	T1-2	21.0	5	2.9	50.0	100
Ohdaira et al[8]	2007	Japan	52	59.7	37/15	T1	_	5	_	100	100
Kusano et al[9]	2008	Japan	22	67.7	9/13	T1-3	_	5	3.6	40.0	100
Koyama et al[10]	2009	Japan	14	56.9	9/5	T1	26.0	5	7.1	100	100
Ohdaira et al[11]	2009	Japan	30	62.9	23/7	T1-2	42.6	5	4.8	100	100
Tajima et al[12]	2009	Japan	56	68.4	30/26	T1-3		5	7.2	64.7	100
Kelder et al[13]	2010	Japan	212	60.0	159/53	T1	30.0	5	6.0	97.0	100
Tajima et al[14]	2010	Japan	38	64.3	25/13	T1-2	33.8	5	7.9	75.0	100
Yano et al[15]	2012	Japan	130	_	_	T1-2	_	0.5	_	100	86.8
Kinami et al[16]	2016	Japan	72	69.3	44/28	T1-3	27.6	0.05	6.0	90.9	100
Takahashi et al[17]	2016	Japan	36	_	_	T1-2		5	9.2	100	100
Takahashi et al[18]	2017	Japan	44	60.9	3519	T1	24.8	5	7.9	100	100
Kim et al[19]	2019	South Korea	28	56.8	16/12	T1	16.0	_	_	100	92.3
Okubo et al[20]	2018	Japan	17	_	_	T1-2	19.6	_	4.5	100	100

ICC: Intraclass correlation coefficient; SLN: Sentinel lymph node; ICG: Indocyanine green; CT: Clinical T stage of the tumor.

Table 2 Meta-subgroup analysis of the sensitivity-based bivariable mixed effects model

Influencing factor	Number	Sensitivity (95%CI)	P value
Optical imaging			< 0.001
Near infrared imaging	10	0.98 (0.96-1.00)
Fluorescence imaging	7	0.73 (0.56-0.91)
Image time			< 0.001
20 minutes after injection	10	0.98 (0.96-1.00)
Immediately after injection	5	0.70 (0.54-0.86)
Average number of SLNS detected			0.010
≥ 4	12	0.96 (0.90-1.00)
< 4	3	0.68 (0.20-1.00)
Pathological staining			< 0.001
IHC + HE	7	0.99 (0.98-1.00)
HE	10	0.84 (0.70-0.98)
Injection site			< 0.001
Submucosal injection	14	0.98 (0.95-1.00)
Subserous injection	2	0.40 (0.18-0.62)
ICG concentration (g/L)			0.010
5	12	0.83 (0.80-0.89)
0.5	3	0.98 (0.93-1.00)
Operation for gastric cancer			0.460
Laparotomy	8	0.95 (0.86-1.00)
Laparoscopic surgery	9	0.96 (0.88-1.00)
Cleaning method			0.200
Lymph node regional dissection	14	0.96 (0.89-1.00)
Lymph node dissection	3	0.96 (0.87-1.00)
Clinical stage of tumor			0.200
cT1	13	0.96 (0.92-1.00)
cT2-3	4	0.72 (0.41-1.00)
Tumor diameter (mm)			0.160
≤ 30	8	0.96 (0.91-1.00)
> 30	3	0.81 (0.64-0.98)

SLN: Sentinel lymph node; ICG: Indocyanine green; IHC: Immunohistochemical; HE: Hematoxylin-eosin staining; cT: Clinical T stage of the tumor.