Flynn Sean M, Burchette Raoul J, Ghassemi Majid, Ratner Oleg, Mandel Danielle, Tomassi Marco J, Klaristenfeld Daniel D
Department of Surgery, University of California, San Diego, California.
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
J Surg Oncol. 2019 May;119(6):766-770. doi: 10.1002/jso.25372. Epub 2019 Jan 16.
Carnoy's fixation and compression represents a novel technique to enhance lymph node evaluation and accuracy of staging after colorectal cancer resection.
This study was performed in all adults undergoing colorectal cancer operations by Kaiser Permanente surgeons at two separate facilities. Patients were assigned to either location based upon surgeon and patient availability. One group of patients had their lymph nodes examined with current standard manual technique (MT). The other group had their specimens fixed with Carnoy's solution and then compressed (CT) to assess for lymph nodes.
A total of 157 patients were enrolled. Seventy-eight patient specimens underwent MT and 79 patient specimens underwent the new compression technique (CT). CT resulted in a significant increase in total lymph node yield per specimen (37.6 ± 18.5 nodes with CT vs 18.9 ± 8.8 nodes with MT; P < 0.0001). CT also resulted in sufficient lymph node sampling (>12 nodes) in all 79 patients in the group compared with 13 of 78 patients (17%) with an insufficient lymph node evaluation in the MT group ( P = 0.0002).
This study demonstrated that Carnoy's fixation with compression can significantly increase lymph node yields in colorectal cancer specimens and allow for a higher rate of adequate lymph node sampling.
卡诺氏固定及加压是一种用于提高结直肠癌切除术后淋巴结评估及分期准确性的新技术。
本研究纳入了在两个不同机构接受凯泽永久医疗集团外科医生进行的结直肠癌手术的所有成年人。根据外科医生和患者的可及性将患者分配至不同地点。一组患者采用当前标准手工技术（MT）检查淋巴结。另一组患者的标本先用卡诺氏液固定，然后进行加压（CT）以评估淋巴结。
共纳入157例患者。78例患者的标本采用MT检查，79例患者的标本采用新的加压技术（CT）。CT使每个标本的总淋巴结检出数显著增加（CT组为37.6±18.5个淋巴结，MT组为18.9±8.8个淋巴结；P<0.0001）。CT组的所有79例患者均获得了足够的淋巴结采样（>12个淋巴结），而MT组的78例患者中有13例（17%）淋巴结评估不足（P=0.0002）。
本研究表明，卡诺氏固定加压可显著增加结直肠癌标本中的淋巴结检出数，并实现更高比例的足够淋巴结采样。
