纳米炭淋巴示踪指导淋巴结清扫在胃癌中的治疗

Value of lymph node tracing using activated carbon nanoparticles as a guidance in lymph node dissection at surgery of gastric cancer

目的：探讨纳米炭淋巴示踪指导淋巴结清扫在胃癌治疗中的价值。方法：选自本院胃肠外科86例进展期远端胃癌患者，分为治疗组和对照组。治疗组42例在手术中局部注射纳米炭进行淋巴结染色指导区域淋巴结清扫；对照组44例实施传统方法的胃癌根治术。比较两组手术中清扫淋巴结的数目、手术时间和复发率。结果：治疗组手术中清扫淋巴结平均（55．23±11．73）个／例，对照组平均（30．97±11．33）个／例，差异有统计学意义（P〈0．05）；N1、N2、N3站淋巴结数差异均有统计学意义（P〈0．05）；治疗组手术时间（217．07±37．19）min，对照组（223．19±40．34）min，差异无统计学意义（P〉0．05）。结论：采用纳米炭淋巴示踪剂指导胃癌根治术淋巴结清扫有利于提高清扫淋巴结的数目和区域清扫的质量，增加临床病理分期和对预后评估的准确性。

Objective：To investigate the value of lymph node tracing using activated carbon nanoparticles as a guidance in lymph node dissection at surgery of gastric cancer. Methods ： 86 patients in our department with advanced distal gastric cancer were divided into the treatment group （n =42） and control group （n = 44）. The treatment group received radical operation of gastric cancer using activated carbon nanoparticles for lymph node tracing as a guidance for lymph node dissection, while the control group received classical modality of operation. Numbers of the dissected lymph nodes, operation time and tumor recurrence were compared between the two groups. Results： A mean of 55.23 ± 11.73 lymph nodes per case in the treatment group vs 30.97 ±11.33 in the control group were dissected at surgery （P 〈 0. 05 ）. The mean operation time was （ 217.07 ± 37.19） rain per ease in the treatment group vs （ 223.19 ± 40.34 ） rain per ease in the control group （P 〉 0.05）. Conclusion： Lymph node dissection guided by activated carbon particle tracing in gastric cancer may contribute to increased number of lymph nodes removed, better outcome of local dissection, elinicopathological staging and accurate estimation of prognosis.