纳米炭在早期宫颈癌前哨淋巴结活检中的应用价值及检出率的影响因素

目的:探究纳米炭混悬液在早期宫颈癌前哨淋巴结活检中的应用价值及前哨淋巴结检出率的影响因素。方法:研究选取大连市妇幼保健院2017年11月到2019年6月手术治疗的FIGO(2009)Ia1-IIa2期宫颈癌患者158例。术前于宫颈注射纳米炭混悬液，术中观察前哨淋巴结显影情况并切除。应用Fisher确切概率法及Logistic回归分析处理数据，探究前哨淋巴结检出率的影响因素。结果:研究中SLN总检出率为86.1%，双侧检出率为60.8%，阴性预测值为98.4%。SLN主要分布于髂外淋巴结、髂内淋巴结及闭孔淋巴结。总检出率的影响因素均无统计学意义。对于双侧检出率，单因素分析及多因素分析中，年龄（P=0.001；P=0.001）、BMI（P=0.019；P=0.021）、术前锥切（P=0.049；P=0.010）的影响均有统计学意义。结论:纳米炭可应用于早期宫颈癌前哨淋巴结活检。病灶<4 cm，年龄及BMI偏低患者应用该技术效果较为可靠，术前锥切患者应用须谨慎。

Application value of carbon nanoparticles in sentinel lymph node biopsy of early cervical cancer and its influencing factors

Objective:To explore the application value of carbon nanoparticles in sentinel lymph node biopsy of early cervical cancer and the influencing factors of sentinel lymph node detection rate.Methods:From November 2017 to June 2019，158 patients with FIGO (2009) Ia1-IIa2 cervical cancer were selected from Dalian Obstetrics and Gynecology Hospital.Carbon nanoparticles was injected into the cervix before operation.The sentinel lymph nodes were observed and resected during operation.Fisher's exact test and Logistic regression analysis were used to explore the influencing factors of sentinel lymph node detection rate.Results:In the study，the total detection rate of SLN was 86.1%，and the bilateral detection rate was 60.8%.The negative predictive value of 98.4%.SLN was mainly distributed in external ilium lymph nodes，internal ilium lymph nodes and obturator lymph nodes.There was no significant difference in the influencing factors of the total detection rate.For bilateral detection rate，single factor analysis and multivariate analysis showed age (P=0.001，P=0.001)，BMI (P=0.019，P=0.021)，preoperative cone cutting (P=0.049，P=0.010) were statistically significant.Conclusion:Carbon nanoparticles can be used in sentinel lymph node biopsy of early cervical cancer.This technique is more reliable in patients with lesions<4 cm，with low age and BMI.Preoperative conization patients should be applied with caution.