纳米炭显影在早期子宫内膜癌分期手术中指导淋巴结切除的临床价值及安全性研究

目的:探究纳米炭显影在早期子宫内膜癌分期手术中指导淋巴结切除的临床价值及安全性。方法:选自2016年5月至2018年10月我院肿瘤妇科接诊并行腹腔镜手术治疗的62例早期子宫内膜癌患者，依据术中使用显影剂的不同，将所有患者分为对照组和观察组。对照组32例术中使用显影剂为吲哚菁绿（ICG），观察组30例术中使用显影剂为纳米炭。观察其临床前哨淋巴结（SLN）检出率、分布、示踪敏感性和阴性预测值（NPV），并分析其安全性。结果:对照组SLN示踪显影总检出率（90.63%，29/32）与观察组总检出率（93.33%，28/30）比较，组间差异无统计学意义（P＞0.05）。对照组SLN显影共383枚，观察组SLN显影共386枚，两组SLN显影均分布于髂内淋巴结、髂外淋巴结、髂前淋巴结、髂总淋巴结、闭孔淋巴结、腹主动脉旁淋巴结及腹股沟深淋巴结等各区域淋巴结组，组间差异无统计学意义（P＞0.05）。对照组总体SLN示踪敏感性为80.00％，NPV为95.83％；观察组总体SLN示踪敏感性为83.33％，NPV为95.65％，两组差异无统计学意义（P＞0.05）。安全性方面两组患者术中未发生中转开腹、SLN相关血管切除、神经损伤等不良情况；术后均未出现发热、皮疹、过敏等并发症。结论:纳米炭在早期子宫内膜癌淋巴结切除术中示踪效果良好、安全，可作为一种新型示踪剂推广使用。

The clinical value and safety of carbon nanoparticle imaging in guiding lymph node resection in early stage endometrial carcinoma

Objective:To explore the clinical value and safety of carbon nanoparticle imaging in guiding lymph node resection in early endometrial carcinoma staging surgery.Methods:From May 2016 to October 2018,62 patients with early endometrial cancer who received gynecological diagnosis and laparoscopic surgery in our hospital were selected.All patients were divided into control group and observation group according to the difference of intraoperative contrast agent.Indocyanine green（ICG) was used in 32 cases of the control group and carbon nanoparticles were used in 30 cases of the observation group.The clinical SLN detection rate,distribution,tracer sensitivity and NPV were observed,and its safety was analyzed.Results:The total detection rate of SLN tracer development in the control group（90.63%,29/32) was not statistically significant（P＞0.05) compared with that in the observation group（93.33%,28/30).There were 383 SLN images in the control group and 386 SLN images in the observation group.SLN images in the two groups were distributed in all regional lymph nodes groups,including internal iliac lymph nodes,external iliac lymph nodes,anterior iliac lymph nodes,common iliac lymph nodes,obturator lymph nodes,para-aortic lymph nodes and deep inguinal lymph nodes,with no statistically significant difference between the two groups（P＞0.05).The SLN tracer sensitivity of the control group was 80.00% and NPV was 95.83%.The SLN tracer sensitivity of the observation group was 83.33% and NPV was 95.65%,and the difference between the two groups was not statistically significant（P＞0.05).In terms of safety,there were no adverse conditions such as laparotomy,SLN-related vascular resection and nerve injury occurred during the operation in the two groups.There were no complications such as fever,rash and allergy after operation.Conclusion:Carbon nanoparticles have good and safe tracer effect in lymphectomy of early endometrial carcinoma,and can be used as a new tracer.