纳米碳示踪技术在胰腺癌根治术中的应用探讨
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摘要
目的探讨纳米碳示踪技术在胰腺癌根治术中的应用价值。方法回顾性分析2013年6月至2016年12月间52例胰腺癌患者的资料,分为纳米碳组和对照组,各26例,纳米碳组术中应用纳米碳示踪剂治疗,对照组则不给予。采用SPSS22.0软件进行统计学分析,围手术期相关指标、淋巴结检获数目和生存时间采用(x±s)表示,独立样本t检验;术后淋巴结阳性比率和并发症发生率比较采用χ2检验,生存率比较用Kaplan-Meier检验,P<0.05差异有统计学意义。结果两组患者手术时间、术中出血量、术后引流量、平均住院时间比较,差异无统计学意义(P>0.05);纳米碳组淋巴结检获数目(26.3±2.5)枚,明显多于对照组(19.4±1.7)枚,其中微小淋巴结(≤5 mm)(8.1±1.7)枚,明显多于对照组(5.3±1.0)枚;纳米碳组阳性淋巴结(11.4±3.1)枚,明显多于对照组(5.9±1.5)枚;检出所需时间(20.4±3.6)min,明显短于对照组(31.8±5.1)min(P<0.05);纳米碳组阳性淋巴结比率为19.5%(168/860),高于对照组的15.7%(115/733)(P<0.05);纳米碳组黑染率为71.2%(612/860),黑染淋巴结阳性比率24.1%(148/612),明显高于未黑染淋巴结阳性比率8.1%(20/248)和对照组淋巴结阳性比率(P<0.05)。纳米碳组第1年、2年、3年的生存率均明显高于对照组(P<0.05);纳米碳组术后平均生存时间为(25.0±13.3)个月,明显多于对照组(15.3±13.0)个月(P<0.05)。结论纳米碳示踪技术应用于胰腺癌根治术可取得良好的淋巴结示踪效果,明显提高淋巴结的检出数目和阳性淋巴结的清扫率,提高术后生存时间,改善患者预后。
Objective To investigate the effect of carbon nanoparticles tracer technique in radical resection of pancreatic cancer. Methods From June 2013 to December 2016,a retrospective analysis was performed in 52 patients with pancreatic cancer treated in our hospital,the patients were divided into carbon nanoparticle group and control group,26 cases in each group,carbon nanoparticle lymphatic tracer was used in carbon nanoparticle group during operation. Statistical analysis was performed by SPSS 22. 0 software,the perioperative indicators,number of lymph nodes and survival time were expressed as mean ± standard deviation,and were examined by using t test. The positive lymph node ratio and post-operative complication rate were examined by using chi square test. The survival rate were examined by using Kaplan-Meier test. A P value of < 0. 05 was considered as significant difference. Results There were no significant differences in the operation time,amount of post-operation drainage,intraoperative blood loss and average hospitalization time between the two groups( P > 0. 05). The average number of lymph nodes in carbon nanoparticle group( 26. 3 ± 2. 5) was significantly more than that( 19. 4 ± 1. 7) in the control group,and the number of lymph nodes whose diameter were less than 5 mm was significantly more than that in the control group[( 8. 1 ± 1. 7)vs.( 5. 3 ± 1. 0) ],the average number of positive lymph nodes in carbon nanoparticle group( 11. 4 ± 3. 1)was significantly more than that( 5. 9 ± 1. 5) in control group; The mean required time for lymph nodes detection in carbon nanoparticle group( 20. 4 ± 3. 6) min was significantly shorter than that in control group( 31. 8 ± 5. 1) min. The positive lymph node ratio in carbon nanoparticle group( 19. 5%,168/860) was significantly higher than that in control group( 15. 7%,115/733). The rate of black-dyed lymph nodes in carbon nanoparticle group was( 71. 2%,612/860). The positive lymph node ratio of black-dyed lymph nodes( 24. 1%,148/612) was significantly higher than that of non-black-dyed lymph nodes( 8. 1%,20/248) and the control group( P < 0. 05). The 1-,2-,3-years survival rate in carbon nanoparticle group were higher than those in control group( P < 0. 05). The mean survival time of carbon nanoparticle group( 25. 0 ± 13. 3 months) was significantly more than that of the control group( 15. 3 ± 13. 0 months)( P < 0. 05). Conclusion The application of carbon nanoparticles tracer technique in radical resection of pancreatic cancer can reach good effect,which increased the number of lymph node and positive lymph node dissection rate,improved the survival time and prognosis of patients.
Objective To investigate the effect of carbon nanoparticles tracer technique in radical resection of pancreatic cancer. Methods From June 2013 to December 2016,a retrospective analysis was performed in 52 patients with pancreatic cancer treated in our hospital,the patients were divided into carbon nanoparticle group and control group,26 cases in each group,carbon nanoparticle lymphatic tracer was used in carbon nanoparticle group during operation. Statistical analysis was performed by SPSS 22. 0 software,the perioperative indicators,number of lymph nodes and survival time were expressed as mean ± standard deviation,and were examined by using t test. The positive lymph node ratio and post-operative complication rate were examined by using chi square test. The survival rate were examined by using Kaplan-Meier test. A P value of < 0. 05 was considered as significant difference. Results There were no significant differences in the operation time,amount of post-operation drainage,intraoperative blood loss and average hospitalization time between the two groups( P > 0. 05). The average number of lymph nodes in carbon nanoparticle group( 26. 3 ± 2. 5) was significantly more than that( 19. 4 ± 1. 7) in the control group,and the number of lymph nodes whose diameter were less than 5 mm was significantly more than that in the control group[( 8. 1 ± 1. 7)vs.( 5. 3 ± 1. 0) ],the average number of positive lymph nodes in carbon nanoparticle group( 11. 4 ± 3. 1)was significantly more than that( 5. 9 ± 1. 5) in control group; The mean required time for lymph nodes detection in carbon nanoparticle group( 20. 4 ± 3. 6) min was significantly shorter than that in control group( 31. 8 ± 5. 1) min. The positive lymph node ratio in carbon nanoparticle group( 19. 5%,168/860) was significantly higher than that in control group( 15. 7%,115/733). The rate of black-dyed lymph nodes in carbon nanoparticle group was( 71. 2%,612/860). The positive lymph node ratio of black-dyed lymph nodes( 24. 1%,148/612) was significantly higher than that of non-black-dyed lymph nodes( 8. 1%,20/248) and the control group( P < 0. 05). The 1-,2-,3-years survival rate in carbon nanoparticle group were higher than those in control group( P < 0. 05). The mean survival time of carbon nanoparticle group( 25. 0 ± 13. 3 months) was significantly more than that of the control group( 15. 3 ± 13. 0 months)( P < 0. 05). Conclusion The application of carbon nanoparticles tracer technique in radical resection of pancreatic cancer can reach good effect,which increased the number of lymph node and positive lymph node dissection rate,improved the survival time and prognosis of patients.
引文
[1]梁丁孔,施思,徐近,等.2016年胰腺癌研究及诊疗进展[J].中国癌症杂志,2017,27(4):241-250.
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[8]葛现才,张勤,徐宪辉,等.纳米碳示踪技术在结肠癌根治术淋巴结清扫中应用价值研究[J].中国实用外科杂志,2016,36(8):904-906.
[9]张志栋,刘庆伟,李勇,等.纳米炭淋巴示踪剂在进展期胃癌根治术中的应用价值[J].中国全科医学,2015,18(3):255-258.
[10]王连才,穆森茂,李德宇,等.纳米炭淋巴示踪指导胰腺癌手术治疗的临床研究[J].中华普通外科杂志,2017,32(6):481-484.
[11]金克敏,王立军,刘伟,等.转移淋巴结数目对胰腺癌患者预后的意义[J].中华普通外科杂志,2016,31(1):17-22.
[12]王卓,刘德军,霍砚淼,等.淋巴结转移对胰腺癌患者生存期的影响[J].中华肝胆外科杂志,2016,22(10):672-676.
[13]方向,麦刚,刘忠亮,等.胰腺癌淋巴结转移情况对预后的影响[J].肝胆胰外科杂志,2017,29(1):27-31.
[2]项金峰,施思,梁丁孔,等.2015年胰腺癌研究及诊疗前沿进展[J].中国癌症杂志,2016,26(4):281-289.
[3]钟志惟,殷香保.胰腺癌的分子靶向治疗研究进展[J].中国普通外科杂志,2016,25(9):1351-1356.
[4]金钢,郑楷炼.胰腺癌手术质量控制[J].中国实用外科杂志,2016,36(1):19-21.
[5]牟一平,金巍巍.腹腔镜手术治疗胰腺癌的现状与展望[J].中华消化外科杂志,2016,15(9):872-877
[6]罗国培,倪泉兴,虞先濬.胰腺癌中淋巴结转移率的临床应用价值[J].中华消化外科杂志,2015,14(8):686-688.
[7]金钢,王槐志,陈汝福.胰腺癌切除与淋巴结清扫范围[J].中国实用外科杂志,2017,37(7):764-765.
[8]葛现才,张勤,徐宪辉,等.纳米碳示踪技术在结肠癌根治术淋巴结清扫中应用价值研究[J].中国实用外科杂志,2016,36(8):904-906.
[9]张志栋,刘庆伟,李勇,等.纳米炭淋巴示踪剂在进展期胃癌根治术中的应用价值[J].中国全科医学,2015,18(3):255-258.
[10]王连才,穆森茂,李德宇,等.纳米炭淋巴示踪指导胰腺癌手术治疗的临床研究[J].中华普通外科杂志,2017,32(6):481-484.
[11]金克敏,王立军,刘伟,等.转移淋巴结数目对胰腺癌患者预后的意义[J].中华普通外科杂志,2016,31(1):17-22.
[12]王卓,刘德军,霍砚淼,等.淋巴结转移对胰腺癌患者生存期的影响[J].中华肝胆外科杂志,2016,22(10):672-676.
[13]方向,麦刚,刘忠亮,等.胰腺癌淋巴结转移情况对预后的影响[J].肝胆胰外科杂志,2017,29(1):27-31.