胃癌D2根治术中纳米碳显影法应用研究

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目的目前认为进展期胃癌分检35枚淋巴结更贴合患者准确病理分期,但常规分检淋巴结方法很难实现。本研究探讨纳米碳显影法在胃癌D2根治术中淋巴结分检中的应用优势。方法回顾性分析2015-10-01-2016-09-30河南省肿瘤医院普外科100例胃癌患者临床资料,按是否应用纳米碳显影分为纳米碳显影组(观察组)和非显影组(对照组),对照2组检出淋巴结总数、平均检出淋巴结数、淋巴结<15枚例数、阳性淋巴结数、淋巴结阳性率、患者转移率、平均直径<5mm数、平均直径<5mm阳性淋巴结数、第1、2站淋巴结数和淋巴结分检时间等指标。结果观察组检出淋巴结总数(3 005枚)和阳性淋巴结总数(509枚)均高于对照组的1 560和305枚。观察组和对照组平均检出淋巴结数分别为62.943±14.507和32.436±5.743,差异有统计学意义,P<0.001;淋巴结分检时间分别为(14.1±2.5)和(17.4±3.2)min,差异有统计学意义,P<0.001;平均直径<5mm数分别为28.972±7.819和9.503±3.390,差异有统计学意义,P<0.001;平均直径<5mm阳性淋巴结分别为17.065±7.610和11.124±8.376,差异有统计学意义,P=0.010;第1(36.605±12.720和19.391±4.518)和第2站淋巴结数(30.110±10.298和14.876±5.396)差异统计学意义,P<0.001;淋巴结阳性率分别为(0.461±0.249)%和(0.453±0.272)%,差异无统计学意义,P=0.948。结论采用纳米碳显影方法在胃癌D2根治术的淋巴结分检中具有操作简便,获取淋巴结数目多,更有利于准确病理分期等优点。 Objective Currently, 35 lymph node dissections of advanced gastric cancer are more suitable for accurate pathological staging of patients, but conventional lymph node dissection method is difficult to achieve. This study was to explore the application advantages of nano-carbon imaging in lymph node dissection in D2 radical gastrectomy. Methods Retrospective analysis 2015-10-01-2016-09-30 Clinical data of 100 cases of gastric cancer patients in Department of General Surgery, Henan Tumor Hospital, according to whether the use of carbon nano-imaging is divided into nano-carbon imaging group (observation group) and non-imaging group Group), control group 2 detected the total number of lymph nodes, the average number of detected lymph nodes, the number of lymph nodes <15, the number of positive nodes, the positive rate of lymph nodes, the patient’s metastasis rate, the average diameter of <5mm, the average diameter <5mm positive nodes, The first and second station lymph node number and lymph node detection time and other indicators. Results The total number of lymph nodes (3 005) and the positive lymph nodes (509) in the observation group were higher than that of the control group (1 560 and 305). The average numbers of lymph nodes in the observation group and the control group were 62.943 ± 14.507 and 32.436 ± 5.743, respectively, with significant difference (P <0.001). The time of lymph node dissection was (14.1 ± 2.5) and (17.4 ± 3.2) min, respectively (P <0.001). The average diameter of less than 5 mm were 28.972 ± 7.819 and 9.503 ± 3.390, respectively, with statistical significance (P <0.001). The positive lymph nodes with an average diameter of less than 5 mm were 17.065 ± 7.610 and 11.124 ± 8.376, The difference was statistically significant (P = 0.010). There were statistically significant differences between the first (36.605 ± 12.720 and 19.391 ± 4.518) and the second (30.110 ± 10.298 and 14.876 ± 5.396) lymph nodes, P <0.001; the positive rates of lymph nodes were (0.461 ± 0.249)% and (0.453 ± 0.272)% respectively, with no significant difference (P = 0.948). Conclusion The method of nano-carbon imaging has the advantages of simple operation, obtaining more lymph nodes and more accurate pathological staging in the lymph node dissection of D2 radical gastrectomy.
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