Sun Jie, Zhang Jingang
Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan 250012, P.R.China.
J BUON. 2018 Mar-Apr;23(2):312-316.
To identify the sentinel lymph node (SLN) in abdominal lymph node metastases of elderly patients with colorectal cancer using carbon nanoparticles (CN).
80 colorectal cancer patients admitted to the affiliated Weihai Second Municipal Hospital of Qingdao University from November 2014 to February 2017 were selected, and divided into the control group (n=40) and the study group (n=40). The control group was treated with surgery, while the study group was administered CN tracer subcutaneously for intraoperative dye positioning; the first to four black-stained lymph nodes were marked as SLN and then radical surgery for CRC followed. Pathological examination of intraoperative specimens was performed to assess SLN metastasis.
There were no statistically significant differences in the distant metastasis rate and SLN metastasis rate between the two groups (p>0.05). The total number of lymph nodes and the number of micro lymph nodes (<2 mm) in the study group was higher compared with the control group (p<0.05); the ratio of <12 lymph nodes in the study group was lower compared with the control group (p<0.05). In the study group, 8 out of 40 cases had SLN metastasis, the detection rate of SLN using CN was 92.50%, the accuracy rate was 94.59%, the specificity of diagnosis was 87.50%, the false negative rate was 12.50% and the negative predictive value was 21.88%. Νo statistically significant difference was noted in the metastasis rate of black-stained lymph nodes and non-black-stained lymph nodes in the study group (p>0.05). The black-stained rate of micro lymph nodes was higher than the total black-stained rate (p<0.05). Τhe rate of micro lymph node metastasis was lower than that of lymph node metastasis >5mm (p<0.05).
Preoperative SLN examination can evaluate the abdominal lymph node status in elderly patients with colorectal cancer, which is simple and accurate and can guide the clinical treatment, so it is worthy of popularization and application.
采用碳纳米颗粒（CN）识别老年结直肠癌患者腹部淋巴结转移中的前哨淋巴结（SLN）。
选取2014年11月至2017年2月在青岛大学附属威海市立第二医院收治的80例结直肠癌患者，分为对照组（n = 40）和研究组（n = 40）。对照组采用手术治疗，研究组皮下注射CN示踪剂用于术中染料定位；将最先出现的4个染成黑色的淋巴结标记为SLN，随后进行结直肠癌根治手术。对术中标本进行病理检查以评估SLN转移情况。
两组患者的远处转移率和SLN转移率差异无统计学意义（p>0.05）。研究组的淋巴结总数和微小淋巴结（<2mm）数量高于对照组（p<0.05）；研究组中<12枚淋巴结的比例低于对照组（p<0.05）。研究组40例中有8例发生SLN转移，CN法检测SLN的检出率为92.50%，准确率为94.59%，诊断特异性为87.50%，假阴性率为12.50%，阴性预测值为21.88%。研究组中染成黑色的淋巴结与未染成黑色的淋巴结转移率差异无统计学意义（p>0.05）。微小淋巴结的染色率高于总体染色率（p<0.05）。微小淋巴结转移率低于>5mm淋巴结的转移率（p<0.05）。
术前SLN检查可评估老年结直肠癌患者的腹部淋巴结状况，操作简单、准确，能指导临床治疗，值得推广应用。
