Department of Breast Surgery, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
Department of Orthopaedic Surgery & Orthopaedic Institute, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
Int J Nanomedicine. 2020 Dec 2;15:9671-9681. doi: 10.2147/IJN.S281914. eCollection 2020.
Accurate lymph node (LN) staging has considerably prognostic and therapeutic value in patients with colorectal cancer (CRC). The purpose of this study is to evaluate the feasibility of applying carbon nanoparticles (CNPs) to track LN metastases in CRC.
Two researchers independently screened publications in PubMed, EMBASE, Cochrane and Ovid MEDLINE databases. The keywords were (carbon nanoparticles OR activated carbon nanoparticles) AND (colon cancer OR rectal cancer OR colorectal cancer). Titles and abstracts of the articles were meticulously read to rule out potential publications. Next, full texts of the ultimately obtained eligible publications were retrieved and analyzed in detail.
The search produced 268 publications, and 140 abstracts were identified after a bibliographic review. Finally, 20 studies relevant to our subject were obtained; however, only 14 papers met our inclusion criteria and were included for final review. All studies included have compared the control group with carbon nanoparticles group (control group, defined as nontattooed group; and carbon nanoparticles group, defined as administering carbon nanoparticles during surgery) for their efficacy in intraoperative detecting and positioning. After analysis, appreciably less amount of bleeding (3/5 trials), shorter operation time (2/4 trials), and shorter time to detect lesions and dissect LNs (2/2 trials) were revealed in CNPs group compared to control group. Thirteen studies have recorded the numbers of the harvested LNs in both groups; meanwhile, CNPs group shows superiority to control group in LN retrieval as well (11/13 trials), which also could effectively aid in locating and harvesting more LNs with diameter below 5 mm.
The tracing technique for CNPs is a safe and useful strategy both in localizing tumor and tracing LNs in CRC surgery. But there is still a need for more randomized controlled trials to further establish its contribution to patient survival.
准确的淋巴结（LN）分期对结直肠癌（CRC）患者具有重要的预后和治疗价值。本研究旨在评估应用碳纳米粒子（CNP）追踪 CRC 中 LN 转移的可行性。
两位研究人员独立筛选了 PubMed、EMBASE、Cochrane 和 Ovid MEDLINE 数据库中的出版物。关键词为（碳纳米粒子或活性炭纳米粒子）和（结肠癌或直肠癌或结直肠癌）。仔细阅读文章的标题和摘要，以排除潜在的出版物。然后，检索并详细分析最终获得的合格出版物的全文。
搜索产生了 268 篇出版物，经过文献回顾，确定了 140 篇摘要。最后，获得了 20 项与我们的主题相关的研究；然而，只有 14 篇论文符合我们的纳入标准，并被纳入最终的综述。所有纳入的研究都比较了对照组和碳纳米粒子组（对照组定义为未纹身组；碳纳米粒子组定义为手术中给予碳纳米粒子）在术中检测和定位方面的效果。分析后发现，碳纳米粒子组的出血量明显减少（3/5 项试验）、手术时间缩短（2/4 项试验）、检测病变和解剖 LN 的时间缩短（2/2 项试验）。13 项研究记录了两组中采集的 LN 数量；同时，碳纳米粒子组在 LN 检索方面也优于对照组（11/13 项试验），这也可以有效地帮助定位和采集更多直径小于 5 毫米的 LN。
CNP 的示踪技术在 CRC 手术中定位肿瘤和追踪 LN 是一种安全有效的策略。但仍需要更多的随机对照试验来进一步确定其对患者生存的贡献。
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