欢迎光临《中华消化外科杂志》官方网站
欢迎您, 游客! 登录 | 注册
首页 » 过刊浏览 » 杂志期刊
《中华消化外科杂志》2018年2月第17卷第2期论著

纳米碳示踪技术联合动脉血管入路淋巴结分检法在乙状结肠癌根治术中的应用价值

阅读全文:
收藏:【点击:221】【下载:80】
引用本文:
赵玉洲,韩广森,霍明科,等.纳米碳示踪技术联合动脉血管入路淋巴结分检法在乙状结肠癌根治术中的应用价值[J].中华消化外科杂志,2018,17(2):168-172.DOI:10.3760/cma.j.issn.1673-9752.2018.02.009.
【摘要】

目的:探讨纳米碳示踪技术联合动脉血管入路淋巴结分检法在乙状结肠癌根治术中的临床应用价值。
方法:采用回顾性队列研究方法。收集2015年12月至2016年6月郑州大学附属肿瘤医院(河南省肿瘤医院)收治的40例乙状结肠癌患者的临床病理资料。40例患者均行乙状结肠癌根治术,其中20例行纳米碳示踪技术联合动脉血管入路法分检淋巴结,设为观察组;20例行传统淋巴结分检法,设为对照组。观察指标:(1)淋巴结检出及病理学检查情况。(2)随访情况。采用门诊和电话方式进行随访,随访内容为:随访期间患者辅助化疗情况、肿瘤复发及转移情况、手术相关并发症情况。随访时间截至2017年6月。正态分布的计量资料以±s表示,组间比较采用t检验。计数资料比较采用X2检验。等级资料比较采用非参数检验。
结果:(1)淋巴结检出及病理学检查情况:40例患者均顺利完成标准的乙状结肠癌根治术。观察组和对照组患者淋巴结分检时间分别为(13.1±2.4)min和(18.4±3.5)min;检出总淋巴结数目分别为522枚和239枚,人均淋巴结检出数目分别为(28.0±7.0)枚和(13.0±3.0)枚;直径<5 mm的总淋巴结数目分别为152枚和64枚,直径<5 mm的人均淋巴结数目分别为(8.6±2.5)枚和(3.9±1.7)枚;淋巴 结<12枚的患者例数分别为0和6例;第1站淋巴结数目分别为(13.7±3.6)枚和(6.1±1.6)枚,第2站淋巴结数目分别为(9.5±2.5)枚和(6.6±2.2)枚,第3站淋巴结数目分别为(4.7±1.2)枚和(2.5±1.0)枚, 两组患者上述指标比较,差异均有统计学意义(t=14.562,24.872,19.256, X2=4.902,t=14.368,10.026,8.210,P<0.05)。观察组和对照组患者总阳性淋巴结数目分别为82枚和43枚,淋巴结阳性率分别为0.22%±0.13%和0.48%±0.18%;患者转移率分别为17/20和7/20;直径<5 mm的总阳性淋巴结数目分别为51枚和38枚,直径<5 mm的人均阳性淋巴结数目分别为(3.9±1.9)枚和(2.7±1.5)枚;第1站阳性淋巴结数目分别为(4.2±1.8)枚和(2.1±0.6)枚,第2站阳性淋巴结数目分别为(1.9±0.6)枚和(2.6±0.7)枚,第3站阳性淋巴结数目分别为(2.3±1.2)枚和(1.4±0.5)枚。两组患者淋巴结阳性率、第3站阳性淋巴结数目比较,差异均无统计学意义(t=1.462,1.759, P>0.05);两组患者的患者转移率、直径<5 mm的人均阳性淋巴结数目、第1站阳性淋巴结数目、第2站阳性淋巴结数目比较,差异均有统计学意义(X2=10.417,t=7.264,4.682,3.410,P<0.05)。(2)随访情况:40例患者均获得随访,随访时间为12~18个月,中位随访时间为16个月。观察组和对照组术后分别有18例和10例患者行辅助化疗,两组比较,差异有统计学意义(X2=5.833, P<0.05)。观察组无患者发生肿瘤复发及转移,对照组2例患者发生肿瘤复发和转移(局部复发 1例、肿瘤肝转移1例),两组比较,差异无统计学意义(X2=2.105, P>0.05)。随访期间两组患者均无手术相关并发症发生。
结论:乙状结肠癌根治术中采用纳米碳示踪技术联合动脉血管入路淋巴结分检法可提高淋巴结分检效率并获取更多淋巴结数目,使术后病理学分期更加准确。

【Abstract】

Objective:To explore the clinical application value of carbon nanoparticles labeled lymph node staining combined with artery approach in radical resection of sigmoid colon cancer.
Methods:The retrospective cohort study was conducted. The clinicopathological data of 40 patients with sigmoid colon cancer who were admitted to the Tumor Hospital of Zhengzhou University (Henan Cancer Hospital) from December 2015 to June 2016 were collected. Among 40 patients undergoing radical resection of sigmoid colon cancer, 20 using nanometer carbon lymph node staining combined with artery approach and 20 using the traditional lymph node sorting were respectively allocated into the observation group and control group. Observation indicators: (1) detection of the lymph node and pathological examination; (2) followup situations. Followup using outpatient examination and telephone interview was performed to detect adjuvant chemotherapy, tumor recurrence or metastasis and surgeryrelated complications up to June, 2017. Measurement data with normal distribution were represented as ±s, and comparisons between groups were evaluated with the t test. Comparisons of count data were analyzed using the chisquare test. The comparisons of ordinal data were analyzed using the nonparametric test.
Results:(1) Detection of the lymph node and pathological examination: 40 patients underwent successful radical resection of sigmoid colon cancer. The lymph node sorting time, total and average numbers of lymph node sorting, total and average numbers of lymph node with diameter < 5 mm, cases with lymph node number <12 and numbers of the first, second and third stations lymph nodes were respectively (13.1±2.4)minutes, 522, 28.0±7.0, 152, 8.6±2.5, 0, 13.7±3.6, 9.5±2.5, 4.7±1.2 in the observation group and (18.4±3.5)minutes, 239, 13.0±3.0, 64, 3.9±1.7, 6, 6.1±1.6, 6.6±2.2, 2.5±1.0 in the control group, with statistically significant differences between groups (t=14.562, 24.872, 19.256, X2=4.902, t=14.368, 10.026, 8.210, P<0.05). The total number of positive lymph node, positive rate of lymph node, metastasis rate of patients, total and average numbers of positive lymph node with diameter <5 mm and numbers of the first, second and third stations positive lymph nodes were respectively 82, 0.22%±0.13%, 17/20, 51, 3.9±1.9, 4.2±1.8, 1.9±0.6, 2.3±1.2 in the observation group and 43, 0.48%±0.18%, 7/20, 38, 2.7±1.5, 2.1±0.6, 2.6±0.7, 1.4±0.5 in the control group, showing no statistically significant difference in the positive rate of lymph node and number of the third station positive lymph nodes between groups (t=1.462, 1.759, P>0.05). There were statistically significant differences in the metastasis rate of patients, average number of positive lymph nodes with diameter <5 mm and numbers of the first and second stations positive lymph nodes between groups (X2=10.417, t=7.264, 4.682, 3.410, P<0.05). (2) Followup situations: 40 patients were followed up for 12-18 months, with a median time of 16 months. Eighteen and 10 patients in the observation group and control group received postoperative adjuvant chemotherapy, showing a statistically significant difference between groups (X2=5.833, P<0.05). Tumor recurrence or metastasis was respectively detected in 0 and 2 patients (1 with local recurrence and 1 with liver metastasis) in the observation group and control group, with no statistically significant difference between groups (X2=2.105, P>0.05). During the followup, there was no surgeryrelated complication.
Conclusion:The carbon nanoparticles labeled lymph node staining combined with artery approach in radical resection of sigmoid colon cancer can increase the sorting rate and number of lymph node, and improve the accuracy of postoperative pathological staging.

DOI:10.3760/cma.j.issn.1673-9752.2018.02.009
基金项目:河南省科技厅科技攻关项目(162102310151)
过刊浏览 优先数字出版

提示:期刊搜索栏可按特定关键词、作者、单位、栏目或日期进行搜索相关期刊。

你也可以直接点击期刊目录进行浏览。

期刊目录
2018 年
2017 年
2016 年
2015 年
2014 年
2013 年
2012 年
2011 年
2010 年
2009 年
2008 年
2007 年