Tingting Li, Canhua Jiang, Jie Chen, Limeng Wu, Ruipu Zhang, Xinchun Jian
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2016 Aug 1;34(4):408-413. doi: 10.7518/hxkq.2016.04.018.
This study aimed to investigate the value of carbon nanoparticles as lymph node tracers in neck dissection for cN0 lingual squamous cell carcinoma patients.
Ninety-six patients with cN0 lingual squamous cell carcinoma were recruited to undergo surgical treatment were randomly divided into two groups, namely, the carbon nanoparticle-labeled group (the experimental group, 50 cases) and the control group (46 cases). Carbon nanoparticle suspension was injected into the submucosal layer around the site of the primary tumor at three or four points (0.1 mL for each point) 12 h before surgery. Supraomohyoid neck dissection (SOHND, Levels Ⅰ to Ⅲ) or comprehensive neck dissection (CND, Levels Ⅰto Ⅴ) were performed based on the size and location of the primary tumor. All the lymph nodes were dissected and separated from the ex vivo surgical specimens for histopathological evaluation. The number, size, location, and pathological result of all the lymph nodes were compared between the two groups. Statistical analyses were conducted by SPSS 19.0 software.
A total of 1 137 lymph nodes were detected in 31 SOHND patients. The average number of lymph nodes detected in the experimental group was (43.79±19.23) /case, which was significantly higher than that in the control group [(30.82±8.77) /case] (P=0.019). Level Ⅲ covered the largest number of lymph nodes in the two groups. However, the number and proportion of lymph nodes found in Level Ⅱ of the experimental group were significantly higher than those of the control group (P=0.000). A total of 3 938 lymph nodes were detected in 65 CND patients. The average number of lymph nodes detected in the experimental group [(66.67±20.02) /case] was larger than that in the control group [(53.03±20.98) /case] (P=0.026). The difference in the lymph node location between the two groups was not statistically significant (P=0.354). In the two neck dissection methods, both the proportion of minute lymph nodes and the accuracy of the detected lymph nodes in the experimental group were significantly larger than those in the control groups (P=0.000). Compared with the control group, more metastases were proven by the carbon nanoparticle-labeled lymph nodes (P=0.000) in the experimental group.
Carbon nanoparticles as lymph node tracers in patients with cN0 lingual squamous cell carcinoma undergoing neck dissection can increase the number of detected lymph nodes, especially the minute nodes. Such nanoparticles can further ensure the thoroughness of neck dissection and the accuracy of clinicopathological stage.
本研究旨在探讨碳纳米颗粒作为cN0舌鳞状细胞癌患者颈部清扫术中淋巴结示踪剂的价值。
96例接受手术治疗的cN0舌鳞状细胞癌患者被随机分为两组，即碳纳米颗粒标记组（实验组，50例）和对照组（46例）。术前12小时在原发肿瘤部位周围的黏膜下层分三到四个点注射碳纳米颗粒混悬液（每点0.1 mL）。根据原发肿瘤的大小和位置进行肩胛舌骨肌上颈部清扫术（SOHND，Ⅰ至Ⅲ区）或根治性颈部清扫术（CND，Ⅰ至Ⅴ区）。将所有淋巴结从离体手术标本中解剖分离出来进行组织病理学评估。比较两组所有淋巴结的数量、大小、位置及病理结果。采用SPSS 19.0软件进行统计学分析。
31例行SOHND的患者共检测到1137枚淋巴结。实验组平均每例检测到的淋巴结数为（43.79±19.23）枚，显著高于对照组[（30.82±8.77）枚]（P = 0.019）。Ⅲ区覆盖的淋巴结数量在两组中最多。然而，实验组Ⅱ区发现的淋巴结数量及比例均显著高于对照组（P = 0.000）。65例行CND的患者共检测到3938枚淋巴结。实验组平均每例检测到的淋巴结数[（66.67±20.02）枚]多于对照组[（53.03±20.98）枚]（P = 0.026）。两组淋巴结位置差异无统计学意义（P = 0.354）。在两种颈部清扫方法中，实验组微小淋巴结的比例及检测到的淋巴结的准确性均显著高于对照组（P = 0.000）。与对照组相比，实验组碳纳米颗粒标记的淋巴结证实有更多转移（P = 0.000）。
碳纳米颗粒作为cN0舌鳞状细胞癌患者颈部清扫术中的淋巴结示踪剂，可增加检测到的淋巴结数量，尤其是微小淋巴结。此类纳米颗粒可进一步确保颈部清扫的彻底性及临床病理分期的准确性。
