纳米碳淋巴示踪技术应用于腹腔镜结直肠癌根治术的意义  

Application of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma

作　　者：杨斌[1] 李英儒[1] 温润龙[1] 江志鹏[1] 张育超[1] 赖东明[1] 陈双[2] 

机构地区：[1]中山大学孙逸仙纪念医院胃肠外科,广州510120 [2]中山大学附属第六医院胃肠外科

出　　处：《中华胃肠外科杂志》2015年第6期549-552,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金（81071761）

摘　　要：目的：探讨纳米碳淋巴结示踪技术在腹腔镜结直肠癌根治术中的应用价值。方法前瞻性收集2011年9月至2013年6月间在中山大学孙逸仙纪念医院接受腹腔镜结直肠癌根治术治疗的患者，采用信封法随机分为淋巴示踪组和未示踪组。淋巴示踪组患者于腹腔镜下距肿瘤周缘0．5～1．0 cm处选择4～6点分别缓慢注射纳米碳混悬液。比较两组术后标本中淋巴结清扫数及转移度，分析淋巴示踪组淋巴结黑染与转移的关系。结果共收集65例患者，其中淋巴示踪组34例，未示踪组31例。淋巴示踪组淋巴结清扫数显著高于未示踪组[（22．3±4．2）枚比（15．4±3．5）枚， P＜0．05]。淋巴示踪组和未示踪组分别共清扫淋巴结725枚和478枚，其中淋巴示踪组清扫的淋巴结中直径小于5 mm者占4．6％（33／725），显著高于未示踪组[2．0％（10／478），P＝0．025]。淋巴示踪组淋巴结黑染度为56．8％（412／725）。黑染淋巴结的转移度为28．6％（118／412），明显高于未黑染淋巴结的转移度[19．5％（61／313），P＝0．005]。结论腹腔镜下纳米碳淋巴示踪技术可提高淋巴结清扫数，特别是对于直径小于5 mm的淋巴结；经淋巴示踪出现黑染的淋巴结出现转移的可能性更大。Objective To evaluate the clinical application of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma. Methods Sixty-five patients undergoing curative laparoscopic resection for colorectal carcinoma in the Sun Yat-sen Memorial Hospital between September 2011 and June 2013 were prospectively enrolled and randomly divided into label group （with carbon nanoparticles, n=34） and control group （without carbon nanoparticles, n=31）. Association between labeled lymph nodes and metastasis was analyzed. The total number of retrieved lymph nodes and lymph nodes metastatic ratio were compared between the two groups. Results Mean number of retrieved lymph node of the label group was higher as compared to the control group （22.3± 4.2 vs. 15.4±3.5, P〈0.05）. The total number of retrieved lymph node was 725 in the label group and 478 in the control group. Among them, lymph node 〈 5 mm accounted for 4.6%（33/725） in the label group, which was higher than 2.0%（10/478） （P=0.025） in the control group. The number of black stain label lymph node was 412, with black stain ratio 56.8%（412/725） in the label group. Metastatic ratio of black stain nodes was significantly higher than that of non-stain nodes [28.6%（118/412） vs. 19.5%（61/313）, P=0.005]. Conclusions The technique of carbon nanoparticles labeled lymph node＆nbsp;staining in curative laparoscopic resection for colorectal carcinoma is easy and effective , which can increase the retrieved number of lymph nodes, especially for nodes 〈 5 mm. The black stain lymph nodes indicate higher risk of metastasis.

关 键 词：结直肠肿瘤 腹腔镜 纳米碳 淋巴结示踪 

分 类 号：R735.34[医药卫生—肿瘤]