纳米碳混悬液示踪早期舌鳞癌前哨淋巴结的临床研究

Clinical study on sentinel lymph node tracked by carbon nanoparticles on early tongue squamous cell carcinoma

目的评估纳米碳混悬液示踪cT1-2N0舌鳞癌前哨淋巴结的效果,进一步探究其在口腔癌前哨淋巴结活检中的应用价值.方法 58例cT1-2N0的舌鳞癌患者被纳入本次前瞻性研究.其中试验组30例患者术前于癌周注射纳米碳混悬液,对照组28例患者术前癌周注射亚甲蓝.所有受试者均接受选择性颈淋巴清扫术.结果试验组较对照组术野清晰,染色淋巴结与周围组织界限清楚.试验组中,纳米碳混悬液对前哨淋巴结的检出率、敏感度、准确率和假阴性率分别为96.7%(29/30)、87.5%(7/8)、93.3%(28/30)和12.5%(1/8);对照组中亚甲蓝对前哨淋巴结的检出率、敏感度、准确率和假阴性率分别为92.8%(26/28)、66.7%(4/6)、85.7%(24/28)和33.3%(2/6),2组差异均无统计学意义(P>0.05).结论纳米碳混悬液有助于前哨淋巴结的检出,注射纳米碳混悬液可作为舌鳞癌前哨淋巴结活检的重要辅助手段.

Objective To investigate the efficacy of earbon-nanopai^ticles suspension in detecting sentinel lymph nodes in cT1-2N0 oral tongue carcinoma and explore the application value of carbon-nanoparticles suspension in sentinel lymph node biopsy. Methods Fifty-eight patients with eT1-2N0 oral tongue carcinoma were enrolled in this prospective trial. Thirty patients received carbon nanoparticle injection around the tumor pre-operatively （ experimental group）, and the remaining 28 were injected with methylene blue dye （ control group）. All patients underwent elective neck dissection and routine pathological examination was performed in all resected specimens. Results The experimental group had a clear surgical fieht compared with the control group, and there is clear boundary between the staining lymph nodes and surrounding tissue. In the experimental group, the detection rate, sensitivity, accuracy rate, and false negative rate of the carbon-nanoparticles suspension were 96.7% （29/30）, 87.5% （7/8）, 93.3% （28/30）, and 12.5% （1/8）, respectively compared with 92.8% （26/28）, 66.7% （4/6）, 85.7% （24/28）, and 33.3% （2/6）, respectively, of the enntrol group. There is no significant difference in both groups （ P 〉 0. 05）. Conclusion The application of carbon-nanoparticles suspension facilitate sentinel lymph node detection and histological evaluation and therefore, could be an important adjunct to sentinel lymph node biopsy in oral tongue squamous cell carcinoma.