纳米碳标记前哨淋巴结在早期宫颈癌诊疗中的价值研究

目的:探讨纳米碳标记前哨淋巴结活检（carbon nanoparticle labeled sentinel lymph node biopsy,SLNB）对早期宫颈癌患者诊疗的应用价值。方法:48例早期宫颈癌患者于宫颈3点、9点分别注射稀释后的纳米碳1 mL，腹腔镜下获取SLN后行广泛全子宫切除+盆腔淋巴结清扫术，切除的SLN及非前哨淋巴结行病理检查。结果:48例患者均检出SLN，平均每例患者检出(3±1.5)枚，显影率为100%，其中闭孔淋巴引流区为检出SLN最多的部位，其次为髂内、髂外和髂总动脉淋巴引流区。术后病理显示4例患者淋巴结阳性，阳性淋巴结共12枚，SLN 10枚，非SLN 2枚，而这4例淋巴结转移患者均被SLNB成功检出。SLNB假阳性率和假阴性率均为0，敏感性为100%（4/4），准确性为100%（48/48），阴性预测值为100%（44/44）。结论:纳米碳标记的SLNB可以准确预测早期宫颈癌患者盆腔淋巴结的转移情况。

The value of carbon nano-labeled sentinel lymph nodes in the diagnosis and treatment of early cervical cancer

Objective:To explore the application value of carbon nanoparticle suspension(CNS) labeled sentinel lymph node biopsy(SLNB) in the diagnosis and treatment of early cervical cancer patients.Methods:48 patients diagnosed with early cervical cancer were injected with 1 mL of carbon nanoparticle into the cervix,extensive hysterectomy+pelvic lymph node dissection was performed after obtaining SLN under laparoscopic surgery.After that,the resected SLN and non-sentinel lymph nodes were subjected to pathological examination.Results:SLNs were detected in all 48 patients,with an average of(3±1.5) per patient,and the imaging rate was 100%.The most frequently detected SLN was the obturator lymphatic drainage area,followed by the internal iliac,external iliac and common iliac arterial lymphatic drainage areas.Postoperative pathology showed that 4 patients had positive lymph nodes,there were 12 positive lymph nodes in total,including 10 SLNs and 2 non-SLNs.These 4 patients with lymph node metastasis were successfully detected by SLNB.The SLNB false positive rate and false negative rate were both 0,the sensitivity was 100%(4/4),the accuracy was 100%(48/48),and the negative predictive value was 100%(44/44).Conclusion:Carbon nanoparticle labeled SLNB can accurately predict pelvic lymph node metastasis in patients with early cervical cancer.