早期胃癌应用纳米炭示踪前哨淋巴结的临床研究

目的 探讨应用纳米炭示踪早期胃癌(EGC)的前哨淋巴结(SN)的最佳方法.方法 在46例EGC患者手术中,将1 mL纳米炭于肿瘤周围分4～6个位点行浆膜下注射,采用3种不同的方式检测SN,将最先染色的淋巴结定义为第一SN(FSN),FSN所在的整组淋巴结认定为整组SN(GSN),将5 min内显色的所有淋巴结标记为全部SN(ASN),术后将认定的SN和其他清扫的淋巴结作病理组织学检查,并进行比较.结果 46例患者均成功检测出SN,其检出率为100％;FSN、GSN、ASN数目分别为(1.04±0.21)、(3.93±1.90)、(13.61±4.36)枚,3种方法检测的SN数目比较差异有统计学意义(P＜0.05);FSN、GSN、ASN对判断胃周淋巴结转移状态的准确率分别为95.65％,100％、100％.结论 纳米炭示踪EGC的SN染色率较高,对预测淋巴结转移有较高的准确性;GSN的准确性高且创伤较小,是最适合的SN检测方法.

Clinical research on application of carbon nanoparticle for tracing sentinel node in early gastric cancer

Objective To explore the application of carbon nanoparticles for tracing sentinel node(SN) in early gastric cancer (EGC).Methods Forty-six patients with EGC conducted subserous injection of carbon nanoparticle solution 1.0 mL at 4-6 points around tumor during operation.SN was examined by adopting 3 different methods.The first stained lymph node was defined as the first SN(FSN),and the whole group lymph nodes were identified as the group SN(GSN) and all lymph nodes colored within 5 min were labeled as the all SN(ASN).The affirmative SN and other resected lymph nodes were performed the histopathological examination and comparison.Resnlts In all 46 cases,SN was successfully detected out with the detection rate of 100％;the number of SN,GSN and ASN were 1.04 ± 0.21,3.93-±-1.90 and 13.61 ± 4.36 respectively,the difference in SN number among 3 different methods had statistical significance(P＜0.05).The accuracy rates of FSN,GSN and ASN for judging perigastric lymph node metastasis status were 95.65％,100％ and 100％,respectively.Conclusion The carbon nanoparticles tracing SN in EGC has higher staining rate and higher accuracy for predicting lymph node metastasis;GSN has high accuracy,moreover has less trauma and is most suitable method for detecting SN.