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目的评价活性炭纳米粒指导胃癌淋巴结清扫的临床应用价值。方法32例胃癌患者术前或术中肿瘤周围注射活性炭纳米粒混悬液,比较其清扫淋巴结的数目、淋巴结黑染及转移情况,并观察副作用的发生。结果活性炭组每例患者清扫的淋巴结数(32.7±11.4枚)明显高于对照组(17.0±8.7枚),主要是清扫的N2淋巴结数明显增多(23.1±8.0枚):(8.7±4.2枚);活性炭组黑染度为58.2%,N1淋巴结的黑染度(66.7%)较N2(49.8%)高;黑染淋巴结中发生淋巴结转移的阳性率(20.7%)明显高于未黑染淋巴结(3.7%)及对照组(15.2%);活性炭组手术时间稍延长,但手术并发症未增加;局部组织注射活性炭纳米粒未见严重副作用发生。结论肿瘤周围局部注射活性炭纳米粒是一种有效、易行和安全的方法,对胃癌淋巴结清扫有指导作用。
Objective To evaluate the clinical value of activated carbon nanoparticles in directing lymph node dissection of gastric cancer. Methods Thirty-two patients with gastric cancer were injected with activated carbon nanoparticles suspension around the tumor before and after operation. The number of lymph nodes and the black dye and metastasis of lymph nodes were compared. The occurrence of side effects was also observed. Results The number of lymph nodes (32.7 ± 11.4) in each activated carbon group was significantly higher than that in the control group (17.0 ± 8.7), the number of N2 lymph nodes was significantly increased (23.1 ± 8.0) (8.7 ± 4.2) ; The black stain of activated carbon group was 58.2%, the positive rate of lymph node metastasis in black lymph node (20.7%) was higher than that of N2 (49.7%) in black lymph node (66.7% 3.7%) and control group (15.2%). The operation time of activated carbon group was slightly longer, but the complications of surgery were not increased. There were no serious side effects of local injection of activated carbon nanoparticles. Conclusion Local injection of activated carbon nanoparticles around the tumor is an effective, feasible and safe method for lymph node dissection of gastric cancer.