纳米炭显影结合动脉途径在直肠癌第三站淋巴结清扫根治术淋巴结分选中的应用价值  

Application value of carbon nanoparticle imaging combined with arterial approach in lymph node sorting during the third station lymph node dissection and radical resection for rectal cancer

作　　者：崔振兴 王新波 CUI Zhenxing;WANG Xinbo(Zhangjiakou Xuangang Hospital,Hebei,Zhangjiakou 075199,China)

机构地区：[1]张家口宣钢医院,河北省张家口市075199

出　　处：《河北医药》2024年第18期2746-2750,共5页Hebei Medical Journal

摘　　要：目的探究纳米炭显影结合动脉途径在直肠癌第三站淋巴结清扫根治术淋巴结分选中的应用价值。方法选取2018年1月至2020年7月就诊于张家口宣钢医院的直肠癌患者110例,根据患者治疗方法不同,将患者分为传统淋巴结分选组(传统淋巴结分选)55例和纳米炭显影结合动脉途径组(纳米炭颗粒悬浮液经肛门注射到肿瘤周围的直肠黏膜下层并结合动脉途径)55例。通过腹部和骨盆的对比增强计算机断层扫描,核磁共振成像和正发射断层扫描验证诊断;比较2组患者淋巴结分选持续时间、淋巴结和直径<5 mm的淋巴结数目;通过综合诊断2组患者淋巴结阳性或阴性;通过苏木精和伊红染色进行组织学检查;比较2组患者直肠膜完整性和肿瘤与周围切除边缘距离;统计2组患者生存率。结果纳米炭显影结合动脉途径组淋巴结分选持续时间较传统淋巴结分选组短(P<0.05)。纳米炭显影结合动脉途径组淋巴结数目和直径<5 mm的淋巴结平均数较传统淋巴结分选组多(P<0.05)。纳米炭颗粒对组织化学观察和诊断没有影响。纳米炭显影结合动脉途径组直肠膜完整性比例和肿瘤与周围切除边缘距离高于传统淋巴结分选组(P<0.05)。纳米炭显影结合动脉途径组术后住院天数和辅助化疗人数比例均低于传统淋巴结分选组(P<0.05)。治疗12个月后,2组患者生存率均出现不同程度下降,但纳米炭显影结合动脉途径组的下降幅度低于传统淋巴结分选组(P<0.05)。结论纳米炭显影结合动脉途径作为直肠癌淋巴结检测示踪剂是有效的,能够增加患者生存率,对直肠癌患者具有保护作用。Objective To study the application value of carbon nanography combined with arterial approach in lymph node sorting during the third-stage lymph node dissection and radical resection for rectal cancer(RC).Methods According to different treatment methods,110 patients with RC admitted to Zhangjiakou Xuangang Hospital from January 2018 to July 2020 were divided into traditional group(traditional lymph node sorting,n=55)and combined group(nano carbon particle suspension was injected into the rectal submucosa around the tumor through anus and combined with arterial approach,n=55).Contrast-enhanced computed tomography(CT),magnetic resonance imaging(MRI)and positron emission tomography(PET)of abdomen and pelvis were performed.The duration of lymph node sorting,the number of lymph nodes and the number of lymph nodes with diameter less than 5 mm were compared between the two groups.The lymph nodes were positive or negative by comprehensive diagnosis,and the histological examination was performed by hematoxylin and eosin staining.The integrity of rectal membrane and the distance between tumor and surrounding resection edge were compared between the two groups;the survival rate of the two groups was calculated.Results The duration of lymph node sorting in the combined group was significantly shorter than that in the traditional group(P<0.05).The number of lymph nodes and the average number of lymph nodes less than 5 mm in diameter in the combined group were significantly more than those in the traditional group(P<0.05).Carbon nanoparticles had no effect on histochemical observation and diagnosis.The proportion of membrane integrity and the distance the distance between tumor and surrounding resection edge in the combined group were significantly higher than those in the traditional group(P<0.05).The postoperative hospital stay and the proportion of patients receiving adjuvant chemotherapy in the combined group were significantly lower than those in the traditional group(P<0.05).After 12 months of treatment,the survival rate

关 键 词：直肠癌 淋巴结分选 纳米炭 自主神经 第三站淋巴结清扫根治术 

分 类 号：R735.37[医药卫生—肿瘤]