中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
6期
409-412
,共4页
彭亦凡%姚云峰%王林%顾晋
彭亦凡%姚雲峰%王林%顧晉
팽역범%요운봉%왕림%고진
结肠肿瘤%放射性示踪剂%前哨淋巴结活组织检查%纳米管,碳
結腸腫瘤%放射性示蹤劑%前哨淋巴結活組織檢查%納米管,碳
결장종류%방사성시종제%전초림파결활조직검사%납미관,탄
Colonic neoplasms%Radioactive tracers%Sentinel lymph node biopsy%Nanolubes,carbon
目的 研究结肠癌根治术中运用纳米碳示踪剂标记结肠癌前哨淋巴结(sentinel lymph node,SLN)的可行性、准确性.方法 将北京大学肿瘤医院于2009年7月至2011年3月间收治的行根治性切除的63例结肠癌患者作为实验组,于根治术中向癌周注射纳米碳注射液共1 ml(50 mg)进行SLN标记显像,分别记录SLN数目及未染色淋巴结数目,术后行病理学检查；选取同期行根治性切除手术中未进行纳米碳示踪剂标记的结肠癌患者90例作为对照组.应用SPSS 17.0软件进行统计学分析,计量资料采用t检验,计数资料采用x2检验,P＜0.05为差异有统计学意义.结果 实验组63例通过注射纳米碳共检出淋巴结1640枚,平均每例26.0枚,SLN检出率100％,获取纳米碳染色淋巴结481枚,平均每例7.6枚.其中发现有淋巴结转移者31例,共发现转移淋巴结198枚,平均每例3.1枚.其中纳米碳染色转移淋巴结34枚,黑染度为17.2％.在获取淋巴结总数和转移淋巴结数目上两组差异有统计学意义(P =0.000,P=0.001).SLN对区域淋巴结转移状况预测的灵敏度为52％,准确性为76％,特异性为100％,假阴性率为48％.剔除实验组中23例T4期患者,40例T分期在T1 ～3的患者SLN对区域淋巴结转移状况预测的灵敏度为79％,准确性为90％,特异性为100％,假阴性率为21％.结论 通过术中注射纳米碳标记SLN检测,能明显提高结肠癌根治术的淋巴结清扫数量,提高肿瘤淋巴结转移的检出率,提高肿瘤分期的准确性.
目的 研究結腸癌根治術中運用納米碳示蹤劑標記結腸癌前哨淋巴結(sentinel lymph node,SLN)的可行性、準確性.方法 將北京大學腫瘤醫院于2009年7月至2011年3月間收治的行根治性切除的63例結腸癌患者作為實驗組,于根治術中嚮癌週註射納米碳註射液共1 ml(50 mg)進行SLN標記顯像,分彆記錄SLN數目及未染色淋巴結數目,術後行病理學檢查；選取同期行根治性切除手術中未進行納米碳示蹤劑標記的結腸癌患者90例作為對照組.應用SPSS 17.0軟件進行統計學分析,計量資料採用t檢驗,計數資料採用x2檢驗,P＜0.05為差異有統計學意義.結果 實驗組63例通過註射納米碳共檢齣淋巴結1640枚,平均每例26.0枚,SLN檢齣率100％,穫取納米碳染色淋巴結481枚,平均每例7.6枚.其中髮現有淋巴結轉移者31例,共髮現轉移淋巴結198枚,平均每例3.1枚.其中納米碳染色轉移淋巴結34枚,黑染度為17.2％.在穫取淋巴結總數和轉移淋巴結數目上兩組差異有統計學意義(P =0.000,P=0.001).SLN對區域淋巴結轉移狀況預測的靈敏度為52％,準確性為76％,特異性為100％,假陰性率為48％.剔除實驗組中23例T4期患者,40例T分期在T1 ～3的患者SLN對區域淋巴結轉移狀況預測的靈敏度為79％,準確性為90％,特異性為100％,假陰性率為21％.結論 通過術中註射納米碳標記SLN檢測,能明顯提高結腸癌根治術的淋巴結清掃數量,提高腫瘤淋巴結轉移的檢齣率,提高腫瘤分期的準確性.
목적 연구결장암근치술중운용납미탄시종제표기결장암전초림파결(sentinel lymph node,SLN)적가행성、준학성.방법 장북경대학종류의원우2009년7월지2011년3월간수치적행근치성절제적63례결장암환자작위실험조,우근치술중향암주주사납미탄주사액공1 ml(50 mg)진행SLN표기현상,분별기록SLN수목급미염색림파결수목,술후행병이학검사；선취동기행근치성절제수술중미진행납미탄시종제표기적결장암환자90례작위대조조.응용SPSS 17.0연건진행통계학분석,계량자료채용t검험,계수자료채용x2검험,P＜0.05위차이유통계학의의.결과 실험조63례통과주사납미탄공검출림파결1640매,평균매례26.0매,SLN검출솔100％,획취납미탄염색림파결481매,평균매례7.6매.기중발현유림파결전이자31례,공발현전이림파결198매,평균매례3.1매.기중납미탄염색전이림파결34매,흑염도위17.2％.재획취림파결총수화전이림파결수목상량조차이유통계학의의(P =0.000,P=0.001).SLN대구역림파결전이상황예측적령민도위52％,준학성위76％,특이성위100％,가음성솔위48％.척제실험조중23례T4기환자,40례T분기재T1 ～3적환자SLN대구역림파결전이상황예측적령민도위79％,준학성위90％,특이성위100％,가음성솔위21％.결론 통과술중주사납미탄표기SLN검측,능명현제고결장암근치술적림파결청소수량,제고종류림파결전이적검출솔,제고종류분기적준학성.
Objective To identify if intraoperative injecting carbon nanoparticles (CNP) is a feasible,precise and safe method of sentinel lymph node mapping (SLNM).Methods In this study,63 colon cancer patients from July 2009 to March 2011 were included.1 ml (50 mg) CNP was locally injected into subserosa around the neoplasm intraoperatively.In comparison 90 colon cancer patients underwent radical resection without CNP injection (control group).After operation both SLN and non-SLN were collected and analyzed compared with the lymphnodes collected in control group.Clinical feasibility,detection rate,and sensitivity of the method were analyzed.The categorical variables were analyzed with the Pearson Chi-square or Fisher's exact test,whereas the continuous variables were analyzed with t test,significance was determined as P ＜ 0.05.Results 1640 lymph nodes were detected in 63 patients(with an average 26.0 per case),SLNs were identified in all cases(100％),481 SLNs were collected (with an average 7.6).Totally 198 metastatic lymph nodes were detected in 31 patients (average 3.1),including 34 metastatic SLNs.Total number of lymph nodes and number of metastatic lymph nodes detected in CNP group were higher than those of control group (P =0.000,P =0.001).The sensitivity,accuracy,specificity and false negative rate were 52％,76％,100％ and 48％ respectively.The sensitivity,accuracy,specificity and false negative rate were adjusted to 79％,90％,100％ and 21％ respectively if all T4 stage patients were excluded.Conclusions SLN detection can increase the number of lymph nodes harvested and improve the detection rate of lymph node metastasis.
