纳米碳标记前哨淋巴结在早期宫颈癌诊疗中的价值研究  

The value of carbon nano-labeled sentinel lymph nodes in the diagnosis and treatment of early cervical cancer

作　　者：张桂芳 尤学武 王颖[3] 韩赛[4] 张友忠[4] ZHANG Guifang;YOU Xuewu;WANG Ying;HAN Sai;ZHANG Youzhong(People's Hospital of Qingzhou,Shandong Qingzhou 262599,China;Peking University People's Hospital,Beijing 100044,China;Yidu Central Hospital of Weifang,Shandong Weifang 262550,China;Qilu Hospital of Shandong University,Shandong Qilu 250012,China.)

机构地区：[1]青州市人民医院,山东青州262599 [2]北京大学人民医院,北京100044 [3]潍坊市益都中心医院,山东潍坊262550 [4]山东大学齐鲁医院,山东齐鲁250012

出　　处：《现代肿瘤医学》2022年第15期2813-2817,共5页Journal of Modern Oncology

基　　金：国家自然科学基金(编号:81572559);山东省重点研发计划(编号:2017CXGC1210)。

摘　　要：目的:探讨纳米碳标记前哨淋巴结活检(carbon nanoparticle labeled sentinel lymph node biopsy,SLNB)对早期宫颈癌患者诊疗的应用价值。方法:48例早期宫颈癌患者于宫颈3点、9点分别注射稀释后的纳米碳1 mL,腹腔镜下获取SLN后行广泛全子宫切除+盆腔淋巴结清扫术,切除的SLN及非前哨淋巴结行病理检查。结果:48例患者均检出SLN,平均每例患者检出(3±1.5)枚,显影率为100%,其中闭孔淋巴引流区为检出SLN最多的部位,其次为髂内、髂外和髂总动脉淋巴引流区。术后病理显示4例患者淋巴结阳性,阳性淋巴结共12枚,SLN 10枚,非SLN 2枚,而这4例淋巴结转移患者均被SLNB成功检出。SLNB假阳性率和假阴性率均为0,敏感性为100%(4/4),准确性为100%(48/48),阴性预测值为100%(44/44)。结论:纳米碳标记的SLNB可以准确预测早期宫颈癌患者盆腔淋巴结的转移情况。Objective:To explore the application value of carbon nanoparticle suspension(CNS)labeled sentinel lymph node biopsy(SLNB)in the diagnosis and treatment of early cervical cancer patients.Methods:48 patients diagnosed with early cervical cancer were injected with 1 mL of carbon nanoparticle into the cervix,extensive hysterectomy+pelvic lymph node dissection was performed after obtaining SLN under laparoscopic surgery.After that,the resected SLN and non-sentinel lymph nodes were subjected to pathological examination.Results:SLNs were detected in all 48 patients,with an average of(3±1.5)per patient,and the imaging rate was 100%.The most frequently detected SLN was the obturator lymphatic drainage area,followed by the internal iliac,external iliac and common iliac arterial lymphatic drainage areas.Postoperative pathology showed that 4 patients had positive lymph nodes,there were 12 positive lymph nodes in total,including 10 SLNs and 2 non-SLNs.These 4 patients with lymph node metastasis were successfully detected by SLNB.The SLNB false positive rate and false negative rate were both 0,the sensitivity was 100%(4/4),the accuracy was 100%(48/48),and the negative predictive value was 100%(44/44).Conclusion:Carbon nanoparticle labeled SLNB can accurately predict pelvic lymph node metastasis in patients with early cervical cancer.

关 键 词：宫颈癌 前哨淋巴结 纳米碳 

分 类 号：R737.33[医药卫生—肿瘤]