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目的探讨纳米炭混悬注射液对术前同步放化疗后直肠癌根治手术标本中淋巴结检出数目的影响。方法回顾性搜集中国医学科学院肿瘤医院2014年3月1日至2015年10月31日期间行术前同步放化疗及根治性手术切除的105例中低位直肠癌患者,其中有36例患者在术前24 h于结肠镜下注射纳米炭混悬注射液(研究组),有69例在术前没有注射纳米炭混悬注射液而直接行手术(对照组),在同样的手术标准和标本病理处理程序下,通过对比分析纳米炭混悬注射液注射对手术标本淋巴结检出情况的影响。结果检出淋巴结总数研究组为764枚,对照组为1 242枚,其中转移淋巴结数研究组为19枚,对照组为58枚。虽然研究组和对照组每例患者平均检出淋巴结数目比较差异无统计学意义〔(21.22±7.13)枚比(18.00±9.84)枚,t=1.739,P=0.085〕,但是每例患者淋巴结检出数目≥12枚者的比例研究组明显高于对照组〔88.9%(32/36)比71.0%(49/69),χ~2=4.287,P=0.038〕。研究组和对照组发现淋巴结转移患者比率比较差异无统计学意义〔27.8%(10/36)比33.3%(23/69),χ~2=0.339,P=0.561〕,每例患者检出的平均转移淋巴结数目在2组间比较差异亦无统计学意义〔(1.90±1.29)枚比(2.52±2.33)枚,t=0.788,P=0.437〕。结论术前结肠镜注射纳米炭混悬注射液可提高直肠癌患者同步放化疗后根治性手术标本中淋巴结检出数目≥12枚患者的比例。
Objective To investigate the effect of nanocarbon suspension injection on the number of lymph nodes in radical resection of rectal cancer after preoperative chemoradiotherapy. Methods Retrospectively collected 105 cases of low and middle rectal cancer patients from March 1, 2014 to October 31, 2015 at Cancer Hospital of Chinese Academy of Medical Sciences undergoing preoperative concurrent chemoradiation and radical surgery. Among them, 36 patients underwent surgery In the first 24 h, NSCLCs (study group) were injected with colonoscopy, and 69 patients underwent direct surgery (control group) without prior injection of nanocarbon suspension injection. In the same surgical criteria and specimen pathology Under the procedure, the influence of nanocarbon suspension injection on the detection of lymph nodes in surgical specimens was analyzed. Results The total number of lymph nodes was 764 in the study group and 1 242 in the control group, of which 19 were in the study group with lymph node metastasis and 58 in the control group. Although there was no significant difference in average number of lymph nodes detected in each group between the study group and the control group (21.22 ± 7.13, 18.00 ± 9.84, t = 1.739, P = 0.085), the lymph node detection The proportion of the study group was significantly higher than those in the control group (88.9% (32/36) vs 71.0% (49/69), χ ~ 2 = 4.287, P = 0.038). There was no significant difference in the rates of lymph node metastasis between study group and control group (27.8% (10/36) vs. 33.3% (23/69), χ ~ 2 = 0.339, P = 0.561) The mean number of metastatic lymph nodes was no significant difference between the two groups [(1.90 ± 1.29) (2.52 ± 2.33), t = 0.788, P = 0.437〕. Conclusion The preoperative colonoscopy injection of nano-carbon suspension injection can increase the proportion of patients with lymph node count> 12 in radical surgical specimens of patients with rectal cancer after concurrent chemoradiotherapy.