染料引导下胃癌淋巴清除术的临床应用

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目的:探讨纳米炭示踪胃癌前哨淋巴结的临床价值。方法:48例胃癌患者随机分为实验组(n=24)和对照组(n=24)。实验组,术中注入纳米炭混悬液(CNP),标记后行胃癌根治术。对照组,未标记直接行胃癌根治术。结果:实验组原发灶平均直径为3.1cm,黑染淋巴结22例(91.67%),共清除淋巴结673枚,平均每例28.04枚,第2、3站淋巴结清除数分别为305和182枚,平均12.71和7.58枚;对照组共清除淋巴结445枚,平均每例18.54枚,第2、3站淋巴结清除数分别为178和86枚,平均7.42和3.58枚。实验组和对照组淋巴结转移率分别为62.5%和33.3%,差异有统计学意义,P<0.05。实验组清除的淋巴结中黑染度为58.10%(391/673)。第1站为41.94%(78/186),第2和3站为61.97%(189/305)和68.13%(124/182),第1站与2和3站差异有统计学意义,χ2=37.85,P<0.01。结论:胃癌根治术中应用纳米碳能增加淋巴结清除数目,使根治术更加彻底。 Objective: To investigate the clinical value of nanocarbon in tracing sentinel lymph node of gastric cancer. Methods: Forty-eight gastric cancer patients were randomly divided into experimental group (n = 24) and control group (n = 24). Experimental group, intraoperative injection of nano-carbon suspension (CNP), marked after radical gastrectomy. Control group, untagged radical gastrectomy. Results: The average diameter of the primary tumor was 3.1cm in the experimental group and 22 cases (91.67%) of the black-stained lymph nodes. A total of 673 lymph nodes were removed, with an average of 28.04 cases. The number of lymph node clearance in the second and third stations were 305 and 182, An average of 12.71 and 7.58; control group, a total of 445 clear lymph nodes, an average of 18.54 cases per case, the second and third station lymphadenectasis were 178 and 86, an average of 7.42 and 3.58. The rates of lymph node metastasis in experimental group and control group were 62.5% and 33.3%, respectively, with statistical significance (P <0.05). The experimental group of clear lymph nodes in the black dye was 58.10% (391/673). The first station was 41.94% (78/186), the second and third stations were 61.97% (189/305) and 68.13% (124/182), the first station and the second and the third station were statistically significant, χ2 = 37.85, P <0.01. Conclusion: The application of nano-carbon in radical operation of gastric cancer can increase the number of lymph node dissection and make the radical operation more complete.
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