纳米炭标记前哨淋巴结在早期宫颈癌中的临床应用

Clinical Application of Carbon Nanoparticle in Sentinel Lymph Node Detection in Patients with Early Cervical Cancer

淋巴结转移与否是判断早期宫颈癌患者预后的独立危险因素和术后是否需要辅助治疗的依据。早期宫颈癌淋巴结转移率较低,大多数患者因无盆腔淋巴结转移而不能从全盆腔淋巴结清扫术中受益。若通过前哨淋巴结(sentinel lymph node,SLN)检测来准确评估早期宫颈癌盆腔淋巴结转移状态,则可以用SLN活检技术替代系统淋巴结清扫术减少手术并发症。虽然目前由于各种原因该项技术未能被临床广泛应用,但纳米炭(carbon nanoparticle,CNP)的出现为其提供了新的契机。CNP具有淋巴系统趋向性和吸附抗癌药物等特点,能在淋巴管、淋巴结高密度且长时间聚集,有利于指导恶性肿瘤的淋巴结清除及淋巴化疗。综述运用CNP混悬液在术前标记早期宫颈癌SLN的可行性,使SLN活检技术替代系统淋巴结清扫术成为可能。

Whether lymph node metastasis or not is an independently risk factor for the prognosis of patients with earlycervical cancer and an evidence for postoperative adjuvant therapy. It is a very low prevalence of lymph node metastasis in earlycervical cancer. And most early cervical cancers with pelvic lymph node metastasis don＇t benefit from the complete pelviclymph node dissection. In order to reduce complications, it suggests that tracing sentinel lymph node （SLN） may accuratelypredict the peivic lymph node,and then the sentinel lymph node biopsy can take place of the complete pelvic lymph nodedissection. Although,it has not yet been odopted as a standard of care,the appearing of carbon nanoparticle （CNP） offers anencouraging opportunity. CNP has the feature of tendency of the lymphatic system and chemotherapy adsorption,and then it cangather in lymphatic vessels and lymph nodes with high density and long time,which is a good guide for malignancy surgery andlymphatic chemotherapy .This review will focus on the feasibility of tracing SLN of early stage cervical cancer before surgery byCNP suspension,which provides the possible replacement of the complete pelvic lymph node dissection for the sentinel lymphnode biopsy.