CAJ | 학술논문

目的探讨纳米碳淋巴结示踪剂在结直肠癌根治术中临床应用的意义.方法采用前瞻性病例对照研究,将60例结直肠癌患者分为两组:30例于术前或术中先向癌灶周围注入钠米碳后再行根治术(标记组),另30例患者则不予注射纳米碳(对照组).分别检测黑染淋巴结与未黑染淋巴结数量及淋巴结转移情况.结果 (1)标记组平均每例清除12.6(6～18)枚淋巴结.淋巴结黑染率为51.9%;对照组平均每例清除8.1(4～14)枚淋巴结.两组比较差异有统计学意义(P＜0.05).(2)标记组黑染淋巴结癌肿侵犯阳性率33.6%,对照组淋巴结阳性率24.7%,两组比较差异有统计学意义(P＜0.05);标记组小于4 mm转移淋巴结检出率高于对照组(P＜0.05).(3)标记组2例直肠癌患者术中发现肠系膜下动脉根部及髂内动脉旁有黑染淋巴结,相应扩大手术切除范围,术后病理证实淋巴结有癌转移.结论纳米碳淋巴结示踪剂染色效果良好,术中易识别,能指导手术医师正确进行淋巴结清除.
목적 탐토납미탄림파결시종제재결직장암근치술중림상응용적의의.방법 채용전첨성병례대조연구,장60례결직장암환자분위량조:30례우술전혹술중선향암조주위주입납미탄후재행근치술(표기조),령30례환자칙불여주사납미탄(대조조).분별검측흑염림파결여미흑염림파결수량급림파결전이정황.결과 (1)표기조평균매례청제12.6(6～18)매림파결.림파결흑염솔위51.9%;대조조평균매례청제8.1(4～14)매림파결.량조비교차이유통계학의의(P＜0.05).(2)표기조흑염림파결암종침범양성솔33.6%,대조조림파결양성솔24.7%,량조비교차이유통계학의의(P＜0.05);표기조소우4 mm전이림파결검출솔고우대조조(P＜0.05).(3)표기조2례직장암환자술중발현장계막하동맥근부급가내동맥방유흑염림파결,상응확대수술절제범위,술후병리증실림파결유암전이.결론 납미탄림파결시종제염색효과량호,술중역식별,능지도수술의사정학진행림파결청제.
Objective To explore the significance of clinical application of carbon nanoparticles labeled lymph node in curative resection for colorectal carcinoma.Methods With perspective cotrolled randomly research， 60 patients with colorectal carcinoma were randomly divided into two groups：carbon nanopartieles was injected into the periphery of the tumor in 30 patients before or during the operation，30 patients were as control without any injection during operation.The number of lymph nodes(dyed or not dyed)and the location of metastasic nodes were recorded separately.Results (1)In the labelling group，the average number of eliminated lymph nodes(12.6，6～18)was significantly more than that of the eontrbl group(8.1，4～14)(P=0.0065).The ratio of dyed lymph nodes was 51.9％.(2)The check-up ratio with histology of metastasic lymph nodes in labelling group was higher than that in the control group.The metastasis rate of dyed lymph nodes 33.6％was more sensitive than the control group 24.7％(P=0.014)，especially for＜4 mm nodes(P=0.0021).(3)In two cases during operation,two dyed lymph nodes were found at the root of inferior mesenteric artery and along the side of internal iliac artery， so we the dissection with positive diagnosis was extended. Conclusion The technique of carbon nanopartieles labeled lymph nodes is easy and effective.The dyed lymph nodes can be easily identified and can be used as a guide for lymph nodes dissection in colorectal carcinoma operation.