纳米碳标识前哨淋巴结在早期宫颈癌淋巴结转移评估中的临床价值

Clinical Application of Carbon Nanoparticles Tracing Sentinel Lymph Nodes to Detect the Metastasis Status in Early-stage Cervical Cancer

目的探讨纳米碳标识前哨淋巴结(sentinel lymph node,SLN)在早期宫颈癌淋巴结转移评估中的临床价值。方法收集早期宫颈癌患者124例,术中应用纳米碳标识SLN,以术后病理为标准,分析SLN的分布、检出率、准确性以及可能的影响因素。结果SLN检出率95.2%。以盆腔淋巴结(pelvic lymph node,PLN)清扫病理结果为“金标准”,SLN评估早期宫颈癌淋巴结转移的灵敏度为100.00%,特异度为98.11%,阳性预测值为85.71%,阴性预测值为100.00%,准确度为98.31%,且与PLN检出的一致性较好(Kappa=0.802)。不同肿瘤体积、是否术前宫颈锥切、淋巴血管间隙浸润、宫颈深部间质浸润及是否进行新辅助化疗患者的SLN检出率差异均无统计学意义(P均>0.05)。结论纳米碳标识SLN对早期宫颈癌淋巴结转移状态的评估有良好的临床应用前景。

Objective To investigate the clinical value of carbon nanoparticles tracing sentinel lymph nodes to detect the metastasis status in early-stage cervical cancer.Method 124 cases of early cervical cancer were prospectively analyzed.Intraoperative injection of carbon nanoparticles tracing sentinel lymph nodes was used to map SLN and the detection accuracy with the pathological diagnosis as the gold standard,meanwhile,possible impact factors were analyzed.Results The detection rate of SLN was 95.2%.Taking the pathological results of pelvic lymph node(PLN)dissection as the"gold standard",the detection sensitivity of SLN was 100%,the specificity was 98.11%,the positive predictive value was 85.71%,the negative predictive value was 100.00%,and the accuracy was 98.31%.It was consistent with the metastatic status of PLN(Kappa=0.802).Tumor size,cervicoconectomy,lymphovascular space invasion,cervical interstitial infiltration,and Neoadjuvant chemotherapy were not suggested statistically to be the impact factors for the SLN detection rate(P all>0.05).Conclusion The approach of carbon nanoparticles tracing SLN has clinical application prospect in the evaluation of pelvic lymph node metastasis status in early cervical cancer.