染料引导下胃癌淋巴清除术的临床应用

Experimental study on the sentinel lymph node of gastric cancer by carbon nanoparticles

目的:探讨纳米炭示踪胃癌前哨淋巴结的临床价值。方法:48例胃癌患者随机分为实验组(n=24)和对照组(n=24)。实验组,术中注入纳米炭混悬液(CNP),标记后行胃癌根治术。对照组,未标记直接行胃癌根治术。结果:实验组原发灶平均直径为3.1cm,黑染淋巴结22例(91.67%),共清除淋巴结673枚,平均每例28.04枚,第2、3站淋巴结清除数分别为305和182枚,平均12.71和7.58枚;对照组共清除淋巴结445枚,平均每例18.54枚,第2、3站淋巴结清除数分别为178和86枚,平均7.42和3.58枚。实验组和对照组淋巴结转移率分别为62.5%和33.3%,差异有统计学意义,P<0.05。实验组清除的淋巴结中黑染度为58.10%(391/673)。第1站为41.94%(78/186),第2和3站为61.97%(189/305)和68.13%(124/182),第1站与2和3站差异有统计学意义,χ2=37.85,P<0.01。结论:胃癌根治术中应用纳米碳能增加淋巴结清除数目,使根治术更加彻底。

OBJECTIVE： To evaluate the clinical application nano carbon in visualization of sentinel lymph node （SLN）in gastric cancer surgery. METHODS：Forty-eight gastric cancer model patients were divided into two groups ran- domly. The firstly 24 patients（experimental group）, Nano-carbon was injected respectively into the gastric wall in model of gastric cancer. The other patients（ control group） were not injected. RESULTS：The mean diameter of primary focal in nan- ometer carbon group was 3.1 cm, and had 22 （91.67 ~） lymph nodes dyed black, eliminated 673 lymph nodes, averagely each person 28.04,the second and third lymph nodes were 305 and 182,averagely each person 12.71 and 7.58. The con- trol group eliminated 445 lymph nodes,averagely each person 18.54,the second and third lymph nodes were 178 and 86, averagely each person 7.42 and 3.58. Lymph node metastasis rates of two groups were 62.5 % and 33.3 %, the difference was statistically significant （P〈0.05）. Cleared Lymph nodes in experimental group had 58.10% （391/673） dyed black, the first was 41.94%（78/186）,and the second and third were 61.97%（189/305） and 68.13%（124/182）,the difference was statistically significant （X2 = 37.85,P%0.01）. CONCLUSIONS： Nanocarbon can be used in radical resection for carci- noma of stomach and add to eliminated lymph nodes ＇ numbers. Accordingly to made radical resection for carcinoma of stomach more complete.