一种对新辅助化疗后胃癌患者纳米碳淋巴示踪方法的应用

A new nano carbon lymph tracing method for gastric cancer patients after neoadjuvant chemotherapy

目的探寻一种提高新辅助化疗胃癌患者淋巴结获取数目的纳米碳淋巴示踪方法。方法回顾性分析2015年1月至2016年3月159例新辅助化疗后胃癌患者的临床资料,其中66例术前1d经内镜在黏膜下层注射纳米碳设为研究组,93例术中使用皮试针头注射浆膜下层设为对照组。结果研究组平均总淋巴结获取数目为(47.0±14.7)枚,对照组为(38.0±14.5)枚,差异有统计学意义,P<0.05;研究组获取的平均纤维化淋巴结数目为(3.1±1.9)枚,对照组为(3.0±1.8)枚,差异无统计学意义,P>0.05;研究组黑染淋巴结数目为(22.3±4.4)枚,对照组为(14.7±4.8)枚,差异有统计学意义,P<0.05;研究组第一站淋巴结平均获取数目为(26.6±8.5)枚,对照组为(24.1±9.9)枚,差异无统计学意义,P>0.05;研究组第二站淋巴结平均获取数目为(20.4±6.9)枚,对照组为(13.8±5.7)枚,差异有统计学意义,P<0.05。结论术前1d经内镜在黏膜下层注射纳米碳较术中在浆膜下层注射纳米碳更能提高新辅助化疗胃癌患者的淋巴结获取个数,尤其是第二站淋巴结数目,有助于提高新辅助化疗胃癌患者术后病理分期的准确性。

Objective To evaluate a new nano-carbon lymphatic tracing method to increase the number of lymph nodes acquired in patients with neoadjuvant chemotherapy for gastric cancer.Method From Jan 2015 to Mar 2016,159 patients with gastric cancer were recruited including 66 cases in study group receiving nano carbon injection under the mucosa layer one day before the operation,and 93 cases with intraoperative subserosal layer injection as control.Results The average number of lymph nodes obtained in the study group was 47.0±14.7,while that in control was 38.0±14.5,P<0.05.The number of fibrotic lymph nodes obtained in the study group was 3.1±1.9,compared with 3.0±1.8 in control,P>0.05.The number of black-stained lymph nodes in the former was 22.3±4.4,and the later was 14.7±4.8,P<0.05.The lymph nodes harvested in the first station in study group was 26.6±8.5,while that in the control group was 24.1±9.9,P>0.05.The lymph nodes obtained in the second station was 20.4±6.9 in study group,while in control was 13.8±5.7,P<0.05.Conclusions The submucosal injection of nanocarbon one day before surgery increase the number of lymph nodes obtained in gastric cancer patients with neoadjuvant chemotherapy.