ABSTRACT
Objective To investigate the tracing value of drug-loaded nano-active carbon for lymphatic visualization and its potential application in the lymphadenectomy of gastric cancer. Methods Sixty-three patients with advanced gastric carcinoma were randomized into 2 groups:control group and tracing group. For the tracing group, 5-Fu-loaded nano-active carbon (NP-5-FU) suspension was intratumorally administered by preoperative gastroscope-guided or intra-operative injection. No tracing reagents was given in the control group. The numbers of removed lymph nodes and metastasis-involved lymph nodes as well as the lymph node staining were recorded and compared between the two groups. The adverse effects was monitored. Results The resected lymph nodes in the tracing group were much more than that of control group (43.73 ± 9. 25 vs. 25. 36 ± 4. 73, t = 3.82,P ＜ 0. 05). For the N1, N2 and N3 lymph nodes, 27. 17 ± 5. 82,13.73 ± 4. 61 and 2. 83 ± 0. 15 per case of the tracing group were desected, while they were 14. 45 ± 2. 75,8. 27 ± 1.89, and 2. 64 ± 0. 11 per case in the control group,respectively (P ＜ 0. 05 ). 26. 2% (211/842) of the lymph nodes in the tracing group showed black intensity,higher than that of unstain lymph nodes (4. 5% ,21/470,χ2 =95. 108,P ＜0. 05) and that in control group (16.9%, 142/837)( χ2 =7.485 ,P ＜ 0.05, ). No local and systemic adverse reactions were observed for the local injection of nano-active carbon. No extension of operating time and increased complications occurred. Conclusion Local injection of nano-active carbon which was loaded with 5-FU around the tumor is a very useful measure to trace the lymph nodes and facilitate the lymphedetectomy and chemotherapy.