纳米炭示踪在结直肠癌根治术淋巴结检出中的应用  

Application of carbon nanoparticles on the detection of lymph nodes in radical resection for colorectal cancer

作　　者：薛芳沁[1,2] 陈鸿源[1,2] 许超[1,2] 郑羽[1,2] 郑晓玲[1,2] 黄良祥[1,2] 

机构地区：[1]福建医科大学省立临床医学院 [2]福建省立医院胃肠外科,福建福州350001

出　　处：《中国医学物理学杂志》2015年第4期490-492,502,共4页Chinese Journal of Medical Physics

基　　金：福建省卫生系统中青年骨干人才培养项目(2014-ZQN-JC)

摘　　要：目的:探讨纳米炭示踪在结直肠癌根治术淋巴结检出中的应用价值。方法:随机将70例结直肠癌患者分为试验组和对照组:试验组术前一天在肠镜引导下于肿瘤周围黏膜下层注射纳米炭再行根治术;对照组直接行根治术。比较两组淋巴结检出及转移情况。结果:试验组检出淋巴结(21.6±6.8)枚/例,淋巴结黑染率为72%,多于对照组的(12.4±3.3)枚/例(P<0.05);检出<5 mm淋巴结(12.5±6.3)枚/例,多于对照组的(3.7±3.0)枚/例(P<0.05)。黑染淋巴结的转移率为19.9%,高于未黑染淋巴结的7.1%和对照组的14.5%(P<0.05)。试验组<5 mm转移淋巴结检出率高于对照组(P<0.05)。结论:纳米炭淋巴结示踪可增加结直肠癌术后淋巴结检出率,尤其是微小淋巴结(<5 mm)检出,有利于提高病理分期准确性。Objective To evaluate the application value of carbon nanoparticles on the detection of lymph nodes in radical resection for colorectal cancer. Methods Seventy patients with colorectal cancer were randomly divided into trail group and control group. One day before surgery, with the guidance of colonoscopy, carbon nanoparticles were injected into the submucosa around the primary tumor in trail group, while the patients in control group routinely underwent radical resection. The detection and metastasis of lymph nodes were compared between these two groups. Results The average number of detected lymph nodes in trail group was （21.6~6.8）, higher than that in control group, （12.4~3.3）, （P〈0.05）. The dyed rate of lymph nodes was 72% in trail group. And the average number of tiny lymph nodes （〈5 mm） was （12.5~6.3） in trail group, higher than that in control group, （3.7~3.0）, （P〈0.05）. The metastasis rate of dyed nodes was 19.9%, significantly higher than that of non-dyed nodes （7.1%）, and that of control group （14.5%）, （P〈0.05）. The metastasis rate of tiny lymph nodes in the trail group was also significantly higher than that in control group （P〈0.05）. Conclusion Carbon nanoparticles could effectively trace the lymph node of colorectal cancer, especially the tiny lymph node, improving the detection rate of lymph nodes, which can improve the accuracy of pathological staging.

关 键 词：纳米炭 结直肠癌 淋巴结 根治术 

分 类 号：R656.9[医药卫生—外科学] R657.1[医药卫生—临床医学]