术前CT淋巴结定位联合纳米碳示踪技术在胃癌根治术中的应用
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摘要
目的探讨术前CT淋巴结定位联合纳米碳示综技术在胃癌根治术中的应用效果。方法选取2016年1月—2017年8月江西省肿瘤医院腹部外科收治的64例拟行胃癌根治术患者作为研究对象,随机分为对照组和联合组;两组患者术前均进行螺旋平扫加增强CT检查,对淋巴结进行术前定位,联合组在此基础上使用纳米碳示踪技术。统计检出淋巴结数目、转移情况及复发率,分析其在胃癌根治术中的指导效果。结果对照组共检出淋巴结737枚,平均每例切除(23.28±8.24)枚,联合组共检出淋巴结963枚,平均每例切除(30.56±7.17)枚,联合组淋巴结检出数与第2站平均检出数高于对照组(P<0.05)。联合组淋巴结转移阳性率为23.47%,高于对照组淋巴结转移率(19.02%)(P <0.05);随访记录显示联合组复发率约为9.37%,低于对照组12.50%的复发率(P<0.05)。结论术前CT定位联合纳米碳示踪技术对胃癌根治术淋巴结清扫具有很好的临床指导意义。
Objective To investigate the efficacy of lymph node localization by preoperative CT combined with carbon nanoscale technique in radical gastrectomy for gastric cancer. Methods Totally 64 cases of gastric carcinoma who were admitted into our hospital from January 2016 to August 2017 for radical surgery were randomly divided into control group and combination group. All patients were performed with spiral plain and enhanced CT examination for preoperative localization lymph node. Patients in the combination group received additional carbon Nano-tracer technology. Results A total of 737 lymph nodes were identified in control group,with an average of(23.28 ± 8.24) lymph nodes eradicated. A total of 963 lymph nodes were detected in combination group, with an average of(30.56 ± 7.17) eradicated. The average number of lymph nodes and second stations in the combinationgroup was significantly higher than those in the control group(P < 0.05). Postoperative pathological results showed that the positive rate of lymph node metastasis in the combination group was increased significantly than that in the control group(23.47% vs 19.02%, P < 0.05). Following up results showed that the recurrence rate for 1.5 years of recurrence rate in the combination group was slightly lower than that in the control group(9.37% vs12.50%). Conclusions Preoperative CT localization combined with carbon Nano tracing technique is of great guiding significance for lymph node dissection in radical gastrectomy.
Objective To investigate the efficacy of lymph node localization by preoperative CT combined with carbon nanoscale technique in radical gastrectomy for gastric cancer. Methods Totally 64 cases of gastric carcinoma who were admitted into our hospital from January 2016 to August 2017 for radical surgery were randomly divided into control group and combination group. All patients were performed with spiral plain and enhanced CT examination for preoperative localization lymph node. Patients in the combination group received additional carbon Nano-tracer technology. Results A total of 737 lymph nodes were identified in control group,with an average of(23.28 ± 8.24) lymph nodes eradicated. A total of 963 lymph nodes were detected in combination group, with an average of(30.56 ± 7.17) eradicated. The average number of lymph nodes and second stations in the combinationgroup was significantly higher than those in the control group(P < 0.05). Postoperative pathological results showed that the positive rate of lymph node metastasis in the combination group was increased significantly than that in the control group(23.47% vs 19.02%, P < 0.05). Following up results showed that the recurrence rate for 1.5 years of recurrence rate in the combination group was slightly lower than that in the control group(9.37% vs12.50%). Conclusions Preoperative CT localization combined with carbon Nano tracing technique is of great guiding significance for lymph node dissection in radical gastrectomy.
引文
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[2]ZHENG H C,GONG B C,ZHAO S.The clinicopathological and prognostic significances of CDC73 expression in cancers:a bioinformatics analysis[J].Oncotarget,2017,8(56):95270-95279.
[3]阴法文,尚磊,张传宝.进展期胃癌患者全胃切除D2淋巴结清扫微创手术效果研究[J].中国普通外科杂志,2015,24(11):1636-1639.
[4]CHEN S,LI Y F,FENG X Y,et al.Significance of palliative gastrectomy for late-stage gastric cancer patients[J].J Surg Oncol,2012,106(7):862-871.
[5]王银中,张艳萍,韩朝阳,等.早期胃癌淋巴结转移的影响因素分析[J].中国普外基础与临床杂志,2017,24(3):328-332.
[6]ZHUO C,YING M,LIN R,et al.Negative lymph node count is a significant prognostic factor in patient with stage IV gastric cancer after palliative gastrectomy[J].Oncotarget,2017,8(41):71197-71205.
[7]CHANG S C,LIU K H,HUNG C Y,et al.Adjuvant chemotherapy improves survival in stage III gastric cancer after D2 surgery[J].JCancer,2018,9(1):81-91.
[8]GOTO A,NISHIKAWA J,HIDEURA E,et al.Lymph node metastasis can be determined by just tumor depth and lymphovascular invasion in early gastric cancer patients after endoscopic submucosal dissection[J].Eur J Gastroenterol Hepatol,2017,29(12):1346-1350.
[9]项田岗,丁建.纳米碳示踪技术在甲状腺癌根治术中的应用[J].中国现代普通外科进展,2017,20(4):322-324.
[10]南润玲,尚培中,张伟,等.乳腺癌手术中纳米碳示踪对淋巴结清扫及神经保护的临床意义[J].河北北方学院学报(自然科学版),2017,33(8):17-20.