纳米碳标记对直肠癌根治术淋巴结检出率的影响

The Influence of Carbon Nanoparticles Labeled Lymph Node on Curative Resection for Rectal Neoplasms

目的探讨纳米碳淋巴结示踪剂在直肠癌根治术淋巴结检出中的临床应用价值.方法选取我院64例直肠癌患者随机分为标记组和对照组,每组32例.标记组在术前或术中先向癌灶周围注入纳米碳示踪剂后再行根治术,对照组不予注射纳米碳示踪剂.比较2组的手术时间、病理标本所检出的淋巴结数量及淋巴结转移情况.结果标记组的手术时间长于对照组,但差异无显著性（P〉0.05）.标记组平均每例清除（18.5±4.5）枚淋巴结,黑染率为54.2%,对照组平均每例清除（13.1±2.3）枚淋巴结,标记组淋巴结检出数明显高于对照组（P〈0.05）.标记组的淋巴结转移率为34.2%高于对照组的20.4%（P〈0.05）.标记组〈5mm淋巴结检出率为37.9%高于对照组的21.7%（P〈0.05）,同时标记组〈5mm转移淋巴结检出率为56.9%高于对照组的32.7%（P〈0.05）.结论纳米碳淋巴结示踪剂染色效果良好,术中易识别,能提高直肠癌根治术中淋巴结的检出率,尤其是小淋巴结的检出率,指导手术医师术中进行淋巴结清除,便于精确术后病理分析.

Objective To explore the value of clinical application of carbon nanoparticles labeled lymph node in curative resection for rectal neoplasms .Methods With perspective research,64 patients with rectal neoplasms were randomized into labeling group and control group equally .Carbon nanoparticles were injected into the periphery of the tumor in 32 patients before or during the operation,and the other 32 patients as control didn＇t have any injection dur-ing the operation.Operation time,detection number of lymph nodes and location of metastatic nodes were compared sepa-rately between two groups.Results The operation time of the labeling group is longer than that of control group but there was no significant difference（P〉0.05）.In labeling group,593 lymph nodes were eliminated （321 dyed）.The ratio of dyed lymph nodes was 54.2%.In control group,the number of eliminated lymph nodes was 465.In labeling group,the average number of eliminated lymph nodes （18.5 ±4.5） was significantly more than that of the control group （13.1 ±2. 3）（P〈0.05）,particularly in 〈5mm nodes（P〈0.05）.The metastasis rate of lymph nodes in labeling group was high-er than that in control group（P〈0.05）,especially significant in 〈5mm nodes（P〈0.05）.Conclusion The technique of carbon nanoparticles labeled lymph nodes is easy and effective .The dyed lymph nodes can be easily identified ,espe-cially the small lymph nodes,which can be used as a guide for lymph nodes dissection in rectal neoplasms operation .And the technique can enhance the detection rate ,which is convenience for pathologic analysis .