Jiang Jiahong, Tang Shuai, Li Yudi, Chen Yin, Chen Xiaoxia, Jiang Maorui, Deng Li, Wang Yanzhou
Department of Obstetrics and Gynecology, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China.
Department of Obstetrics and Gynecology, the 958th Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Heliyon. 2024 Aug 17;10(16):e36307. doi: 10.1016/j.heliyon.2024.e36307. eCollection 2024 Aug 30.
Carbon nanoparticle (CNP)-guided sentinel lymph node biopsy (SLNB) has been extensively adopted as a cost-effective and highly efficient method for tracing malignant tumors except for those associated with vulvar cancer. The current study aimed to validate the feasibility and efficacy of CNPs in tracking sentinel lymph nodes (SLNs) in patients with early vulvar cancer.
We retrospectively reviewed patients with vulvar cancer at our institution from January 2016 to April 2022 who were pathologically diagnosed and underwent SLNB or inguinofemoral lymphadenectomy (IFLND). CNPs were the only lymphatic tracer used in SLNB. Patient demographics, perioperative outcomes and follow-up results, including overall survival (OS) and progression-free survival (PFS), were compared between the SLNB and IFLND groups.
Data from 52 patients were collected and investigated. Forty groins of 22 patients who underwent SLNB with CNP tracing were included. Black-stained SLNs were detected in 32 groins of 19 patients, and the rates of CNP detection by patient and by groin were 86.4 % and 80 %, respectively. Patients who underwent SLNB had better perioperative outcomes than those who underwent IFLND in certain aspects (groin drainage rate: 41.2 % and 80 %, respectively, p < 0.05; daily drainage volume (ml): 12.49 and 36.4, respectively, p < 0.05; and inguinal wound healing rate: 100 % and 80 %, respectively, p < 0.05). The results of survival analysis indicated similar prognoses for node-negative patients who underwent CNP-guided SLNB or IFLND.
Sentinel lymph node mapping with CNPs in vulvar cancer is feasible and demonstrates considerable biosecurity. With a satisfactory SLN detection rate achieved expediently, CNPs are a promising lymphatic tracer worthy of further utilization in vulvar cancer and could be an alternative option to canonical tracers.
碳纳米颗粒（CNP）引导的前哨淋巴结活检（SLNB）已被广泛采用，作为一种经济高效的恶性肿瘤追踪方法，但外阴癌相关的肿瘤除外。本研究旨在验证CNP在早期外阴癌患者中追踪前哨淋巴结（SLN）的可行性和有效性。
我们回顾性分析了2016年1月至2022年4月在我院经病理诊断并接受SLNB或腹股沟股淋巴结清扫术（IFLND）的外阴癌患者。CNP是SLNB中唯一使用的淋巴示踪剂。比较了SLNB组和IFLND组患者的人口统计学、围手术期结果和随访结果，包括总生存期（OS）和无进展生存期（PFS）。
收集并研究了52例患者的数据。其中包括22例行CNP追踪SLNB的患者的40个腹股沟区。在19例患者的32个腹股沟区检测到黑色染色的SLN，患者和腹股沟区的CNP检测率分别为86.4%和80%。在某些方面，接受SLNB的患者围手术期结果优于接受IFLND的患者（腹股沟引流率分别为41.2%和80%，p<0.05；每日引流量（ml）分别为12.49和36.4，p<0.05；腹股沟伤口愈合率分别为100%和80%，p<0.05）。生存分析结果表明，接受CNP引导的SLNB或IFLND的淋巴结阴性患者预后相似。
CNP在外阴癌前哨淋巴结定位中是可行的，并且具有相当的生物安全性。由于能快速达到令人满意的SLN检测率，CNP是一种有前景的淋巴示踪剂，值得在外阴癌中进一步应用，并且可能成为传统示踪剂的替代选择。
