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纳米碳标记前哨淋巴结在早期宫颈癌诊疗中的价值研究

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

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【作者】 张桂芳尤学武王颖韩赛张友忠

【Author】 ZHANG Guifang;YOU Xuewu;WANG Ying;HAN Sai;ZHANG Youzhong;People’s Hospital of Qingzhou;Peking University People’s Hospital;Yidu Central Hospital of Weifang;Qilu Hospital of Shandong University;

【通讯作者】 张友忠;

【机构】 青州市人民医院北京大学人民医院潍坊市益都中心医院山东大学齐鲁医院

【摘要】 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。

【Abstract】 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 all48 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.

【基金】 国家自然科学基金(编号:81572559);山东省重点研发计划(编号:2017CXGC1210)
  • 【文献出处】 现代肿瘤医学 ,Journal of Modern Oncology , 编辑部邮箱 ,2022年15期
  • 【分类号】R737.33
  • 【下载频次】105
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