纳米碳标记在结直肠癌根治术中的应用  

Clinical application of carbon nanoparticles labeled lymph node in curative resection for colorectal carcinoma

作　　者：傅骏[1] 郁宝铭[1] 卞国伟[2] 张敏[1] 陈利文[1] 

机构地区：[1]江苏大学附属上海市第八人民医院结直肠外科结直肠中心,上海200232 [2]江苏大学附属上海市第八人民医院结直肠外科病理科,上海200232

出　　处：《结直肠肛门外科》2009年第3期160-162,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨钠米碳淋巴结示踪剂在结直肠癌根治术中临床应用的意义。方法采用前瞻性病例对照研究,60例结直肠癌患者随机分为两组:30例患者于术前或术中先向癌灶周围注入钠米碳后再行根治术,30例对照组患者则不予注射纳米碳。分别记录检测黑染淋巴结与未黑染淋巴结数量及淋巴结转移情况。结果(1)钠米碳标记组平均每例清除12.6个淋巴结(6～18个),淋巴结黑染率为51.9%。对照组平均每例清除8.1个淋巴结(4～14个)。标记组淋巴结检出数明显高于对照组(P=0.0065)。(2)标记组黑染淋巴结癌肿侵犯阳性率33.6%,对照组淋巴结阳性率24.7%,标记组黑染淋巴结转移率高于对照组(P=0.014),同时标记组<4mm转移淋巴结检出率高于对照组(P=0.0021)。(3)2例直肠癌患者术中发现肠系膜下动脉根部及髂内动脉旁有黑染淋巴结,并相应扩大手术切除范围,术后病理证实淋巴结有癌转移。结论钠米碳淋巴结示踪剂染色效果良好,术中易识别,能指导手术医师术中正确制定手术方案进行淋巴结清除。Objective To explore the significance of clinical application of carbon nanoparticles labeled lymph node in curative resection for coloreetal carcinoma. Methods With perspective research, 60 patients with colorectal carcinoma were randomized into two groups： carbon nanoparticles were injected into the periphery of the tumor in 30 patients before or during the operation, and 30 patients were as control without any injection during operation. The number of lymph nodes （dyed or not dyed） and the location of metastatic nodes were recorded separately. Results （1） In the labelling group, the average number of eliminated lymph nodes（12.6, 6-18）is significantly more than that of the control group（8.1, 4-14）（ P =0. 0065）. The ratio of dyed lymph nodes was 51.9%. （2） The metastasis rate of dyed lymph nodes in labelling group was higher than that in the control group （33.6% vs. 24.7%, P =0. 014）, especially significant in 〈4mm nodes （ P =0. 0021）. （3） During operation, two dyed lymph nodes in two cases were found at the root of inferior mesenteric artery and along the side of internal iliae artery, so the dissection was extended and the dyed lymph nodes were confirmed to be positive. Conclusion The technique of carbon nanoparticles labeled lymph nodes is easy and effective. The dyed lymph nodes can be easily identified and can used as a guide for lymph nodes dissection in colorectal carcinoma operation.

关 键 词：结肠直肠肿瘤 淋巴转移 活性碳 

分 类 号：R735.37[医药卫生—肿瘤]