纳米碳淋巴结示踪剂在结直肠癌根治术中临床应用的意义

Application Significance of Nano-Carbon Lymph Gland Tracer on Radical Resection for Colorectal Cancer

目的探讨纳米碳淋巴结示踪剂在结直肠癌根治术中的临床应用意义。方法选取2015年9月—2017年8月我院收治的结直肠癌患者150例作为研究对象,将其随机分为三组,每组50例,设为A组、B组和C组,其中A组患者在术前1 d注射纳米碳淋巴结示踪剂,B组患者在术中注射纳米碳淋巴结示踪剂,C组患者不做任何处理,比较各组患者的淋巴结检出及染色情况,并分析不同分期患者的淋巴结染色量与染色率。结果 A组患者的淋巴结、微小淋巴结平均检出数、染色淋巴结平均数均显著高于B组,同时高于C组,每两组不同指标之间的比较均有统计学差异(P<0.05)。对不同分期患者的淋巴结染色情况进行比较可见,随着患者临床分期的增加,染色淋巴结数量呈现出先升高后降低的情况,染色率则呈现出下降的情况,总体上看,A组患者各期染色淋巴结数量均显著高于B组,比较差异均有统计学意义(P<0.05),但染色率的比较差异无统计学意义(P>0.05)。结论在实施结直肠癌根治术前一天,通过在肿瘤周围黏膜下注射纳米碳示踪剂可大大提高淋巴结检出率,避免因淋巴结的直径过小导致清扫不彻底的情况;同时,有利于对患者进行更加准确的病理分期,为其术后辅助放化疗提供指导,促进其预后效果的提升。

Objective To investigate the application significance of nanocarbon lymph gland tracer on radical resection for colorectal cancer. Methods 150 cases with colorectal cancer in our hospital from September 2015 to August 2017 were selected and randomly divided into three groups, 50 cases in each group. Group A was given nano carbon lymph gland tracer 1 d before surgery, group B was given nano carbon lymph gland tracer during surgery, group C was given no treatment, lymph gland detection and dyeing conditions of the three groups were compared, quantity of dyeing and dyeing rate of patients at different stage were analyzed. Results Lymph gland, tiny lymph node average detected number, staining lymph node average number of group A were all significantly higher than those in the group B and C, the difference of different indexes was statistic significant（P〈0.05）. Along with the increasing of clinical stages, staining lymph node number exhibited increase first and then decrease, dyeing rate showed decrease. In general, staining lymph node number of group A at each stage was significantly higher than that in the group B, the difference was statistic significant（P〉0.05）, but the difference of dyeing rate between the two groups had no statistic significance（P〉0.05）. Conclusion The application of nano carbon lymph gland tracer under mucous membrane at the area around the tumor can increase lymph gland detection rate, avoid unthoroughness of cleaning caused by small diameter of lymph nodes; at the same time, it is benefit for accurate pathological stage, it can also provide guidance for postoperative adjuvant chemoradiotherapy and promote prognosis effect.