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碳纳米颗粒在早期宫颈癌患者腹腔镜前哨淋巴结检测中的应用。

Application of carbon nanoparticles in laparoscopic sentinel lymph node detection in patients with early-stage cervical cancer.

作者信息

Lu Yan, Wei Jin-Ying, Yao De-Sheng, Pan Zhong-Mian, Yao Yao

机构信息

Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guang Xi Medical University, Nanning, People's Republic of China.

出版信息

PLoS One. 2017 Sep 5;12(9):e0183834. doi: 10.1371/journal.pone.0183834. eCollection 2017.

Abstract

OBJECTIVE

To investigate the value of carbon nanoparticles in identifying sentinel lymph nodes in early-stage cervical cancer.

METHODS

From January 2014 to January 2016, 40 patients with cervical cancer stage IA2-IIA, based on the International Federation of Gynecology and Obstetrics (FIGO) 2009 criteria, were included in this study. The normal cervix around the tumor was injected with a total of 1 mL of carbon nanoparticles (CNP)at 3 and 9 o'clock. All patients then underwent laparoscopic pelvic lymph node dissection and radical hysterectomy. The black-dyed sentinel lymph nodes were removed for routine pathological examination and immunohistochemical staining.

RESULTS

Among the 40 patients, 38 patients had at least one sentinel lymph node (SLN). The detection rate was 95% (38/40). One hundred seventy-three SLNs were detected with an average of 3.9 SLNs per side. 25 positive lymph nodes, which included 21 positive SLNs, were detected in 8 (20%) patients. Sentinel lymph nodes were localized in the obturator (47.97%), internal lilac (13.87%), external lilac (26.59%), parametrial (1.16%), and common iliac (8.67%) regions. The sensitivity of the SLN detection was 100% (5/5), the accuracy was 97.37% (37/38), and the negative predictive value was 100. 0% and the false negative rate was 0%.

CONCLUSIONS

Sentinel lymph nodes can be used to accurately predict the pathological state of pelvic lymph nodes in early cervical cancer. The detection rates and accuracy of sentinel lymph node were high. Carbon nanoparticles can be used to trace the sentinel lymph node in early cervical cancer.

摘要

目的

探讨碳纳米颗粒在早期宫颈癌前哨淋巴结识别中的价值。

方法

2014年1月至2016年1月,根据国际妇产科联盟(FIGO)2009标准,纳入40例IA2-IIA期宫颈癌患者。在肿瘤周围正常宫颈的3点和9点处共注射1 mL碳纳米颗粒(CNP)。所有患者随后接受腹腔镜盆腔淋巴结清扫术和根治性子宫切除术。切除染成黑色前哨淋巴结进行常规病理检查和免疫组织化学染色。

结果

40例患者中,38例患者至少有1个前哨淋巴结(SLN)。检出率为95%(38/40)。共检测到173个SLN,平均每侧3.9个SLN。8例(20%)患者检测到25个阳性淋巴结,其中包括21个阳性SLN。前哨淋巴结位于闭孔(47.97%)、髂内(13.87%)、髂外(26.59%)、宫旁(1.16%)和髂总(出8.67%)区域。SLN检测的敏感性为1%(5/5),准确性为97.37%(37/38),阴性预测值为100.0%,假阴性率为0%。

结论

前哨淋巴结可用于准确预测早期宫颈癌盆腔淋巴结的病理状态。前哨淋巴结的检出率和准确性较高。碳纳米颗粒可用于早期宫颈癌前哨淋巴结的示踪。

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