[1]郭祥翠,王倩青,李 力,等.纳米炭与吲哚菁绿在腹腔镜早期宫颈癌根治术中前哨淋巴结示踪效果比较[J].新乡医学院学报,2020,37(10):955-958.[doi:10.7683/xxyxyxb.2020.10.012]
 GUO Xiangcui,WANG Qianqing,LI Li,et al.Comparison of sentinel lymph node tracking effect between carbon nanonarticles and indocyanine green in laparoscopic radical hysterectomy for early cervical cancer[J].Journal of Xinxiang Medical University,2020,37(10):955-958.[doi:10.7683/xxyxyxb.2020.10.012]
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纳米炭与吲哚菁绿在腹腔镜早期宫颈癌根治术中前哨淋巴结示踪效果比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年10
页码:
955-958
栏目:
临床研究
出版日期:
2020-10-05

文章信息/Info

Title:
Comparison of sentinel lymph node tracking effect between carbon nanonarticles and indocyanine green in laparoscopic radical hysterectomy for early cervical cancer
作者:
郭祥翠王倩青李 力李 君郜智慧陈贝贝苏晓科
(新乡市中心医院,新乡医学院第四临床学院妇科妇瘤科,河南 新乡 453000)
Author(s):
GUO XiangcuiWANG QianqingLI LiLI JunGAO ZhihuiCHEN BeibeiSU Xiaoke
(Department of Gynecological Oncology,Xinxiang Central Hospital,the Fourth Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,Henan Province,China)
关键词:
早期宫颈癌前哨淋巴结腹腔镜手术纳米炭吲哚菁绿
Keywords:
early cervical cancersentinel lymph nodelaparoscopic operationcarbon nanonarticlesindocyanine green
分类号:
R737.33
DOI:
10.7683/xxyxyxb.2020.10.012
文献标志码:
A
摘要:
目的 比较纳米炭与吲哚菁绿在腹腔镜早期宫颈癌根治术中示踪前哨淋巴结(SLN)的应用效果,为临床使用淋巴结示踪剂提供参考。方法 选择2016年9月至2018年12月新乡市中心医院收治的75例早期宫颈癌患者为研究对象,所有患者行腹腔镜下广泛全子宫切除术及盆腔淋巴结清扫术,根据使用的SLN示踪剂将患者分为纳米炭组(n=50)和吲哚菁绿组(n=25),宫颈注射示踪剂后腹腔镜下识别黑染淋巴结或绿色荧光淋巴结即为SLN,切除SLN后进行活检,然后行盆腔淋巴结清扫术及广泛全子宫切除术,切除的所有淋巴结行常规病理学检查和(或)免疫组织化学染色。结果 纳米炭组50例患者共切除淋巴结1 476个,共检测SLN 445个,占淋巴结总数的30.15%(445/1 476);SLN检出率、准确率、特异度、灵敏度、阴性预测值分别为78.0%(39/50)、100.0%(39/39)、76.0%(38/50)、100.0%(1/1)、100.0%(38/38)。吲哚菁绿组25 例患者共切除淋巴结1 006个,共检测SLN 466个,占淋巴结总数的44.33%(446/1 006);SLN检出率、准确率、特异度、阴性预测值均为100.0%(25/25)。吲哚菁绿组患者SLN检出率和特异度显著高于纳米炭组(P<0.05),2组患者SLN准确率及阴性预测值比较差异无统计学意义(P>0.05)。纳米炭组患者手术时间为(218.6±26.9)min,术中出血量为(116.58±84.6)mL;吲哚菁绿组患者手术时间为(202.2±32.6)min,术中出血量为(89.60±45.3)mL;吲哚菁绿组患者手术时间显著短于纳米炭组,术中出血量显著少于纳米炭组(P<0.05)。结论 纳米炭和吲哚菁绿在早期宫颈癌手术中示踪SLN均有良好的应用价值,而吲哚菁绿荧光检测法在视觉效果上更为突出,可显著缩短手术时间,降低术中出血量。
Abstract:
Objective To compare the effect of carbon nanonarticles and indocyanine green in tracing the sentinel lymph node (SLN) in laparoscopic radical surgery for early cervical cancer,so as to provide references for the clinical selection of lymph node tracers.Methods Seventy-five patients with early cervical cancer admitted to Xinxiang Central Hospital from September 2016 to December 2018 were selected as the research subjects.All patients were performed with laparoscopic radical hysterectomy and pelvic lymph node dissection,and the patients were divided into carbon nanonarticles group (n=50) and indocyanine green group (n=25) according to the SLN tracer.After the tracer was injected into the cervix,the black stained lymph nodes or green fluorescent lymph nodes under laparoscope were SLN.The SLNs were resected and biopsied.Then the pelvic lymphadenectomy and extensive hysterectomy were performed.All the lymph nodes were examined by routine pathology and(or) immunohistochemical staining.Results In the 50 patients of the carbon nanonarticles group,1 476 lymph nodes were resected and 445 SLNs were detected,accounting for 30.15% (445/1 476) of the total lymph nodes.The detection rate,accuracy,specificity,sensitivity and negative predictive value of SLN were 78.0%(39/50),100.0%(39/39),76.0% (38/50),100.0%(1/1) and 100.0%(38/38),respectively.In the 25 patients of the indocyanine green group,1 006 lymph nodes were resected and 466 SLNs were detected,accounting for 44.33%(446/1 006) of the total lymph nodes.The detection rate,accuracy,specificity and negative predictive value of SLN were 100.0%(25/25).The detection rate and specificity of SLN in the indocyanine green group were significantly higher than those in the carbon nanonarticles group(P<0.05),but there was no significant difference in accuracy and negative predictive value between the two groups(P>0.05).In the carbon nanonarticles group,the operation time was (218.6±26.9) min,and the intraoperative bleeding was (116.58±84.6) mL.In the indocyanine green group,the operation time was (202.2±32.6) min,and the intraoperative bleeding was (89.60±45.3) mL.The operation time was significantly shorter and the intraoperative bleeding was significantly less in the indocyanine green group than those in the carbon nanonarticles group (P<0.05).Conclusion Both carbon nanonarticles and indocyanine green have good application value in tracking SLN in early cervical cancer surgery,and indocyanine green fluorescence detection method is more prominent in visual effect,which can significantly shorten the operation time and reduce intraoperative bleeding.

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更新日期/Last Update: 2020-10-05