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Objective:To investigate the influence of different injection time of carbon nanoparticle tracer on the acquisition of lymph nodes in adenocarcinoma of esophagogastric junc-tion (AEG) treated by neoadjuvant chemoradiotherapy (nCRT) combined with surgical resection.Methods:The prospective randomized controlled study was conducted. The clinicopathological data of 120 AEG patients who were treated by nCRT combined with surgical resection in the Fourth Hospital of Hebei Medical University from March 2020 to March 2021 were selected. Based on random number table, patients were allocated into two groups. Patients undergoing endoscopic injection of carbon nanoparticle tracer 24 hours before nCRT were allocated into the experiment group, and patients undergoing endoscopic injection of carbon nanoparticle tracer 24 hours before surgical resection were allocated into the control group. All patients received the same plan of nCRT combined with D 2 radical gastrectomy. Observation indicators: (1) grouping situations of the enrolled patients; (2) surgical and postoperative pathological situations; (3) postoperative complications and treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement date with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Results:(1) Grouping situations of the enrolled patients. A total of 120 patients were selected for eligibility. There were 85 males and 35 females, aged (60±9)years. There were 60 patients in the experiment group and 60 patients in the control group, respectively. (2) Surgical and postoperative pathological situations. Patients in the two groups underwent D 2 radical gastrectomy successfully, with R 0 resection. The number of lymph nodes harvest, the number of lymph nodes stained, the number of metastatic lymph nodes stained, the number of micro lymph nodes, the number of inferior mediastinal lymph nodes, the number of inferior mediastinal lymph nodes stained, cases in postoperative pathological stage N0, stage N1, stage N2, stage N3a were 40.6±13.9,20.1±7.7, 1.0(0,3.0), 8.1±2.8, 3.7±1.3, 2.0(1.0,2.0), 18, 13, 23, 6 in patients of the experiment group, respectively. The above indicators were 30.4±8.3, 12.7±3.5, 0(0,1.0), 6.2±2.0, 2.4±1.2, 1.0(0,1.0), 23, 21, 15, 1 in patients of the control group, respectively. There were significant differences in the above indicators between the two groups ( t=-5.01, 6.85, Z=-3.78, t=-4.04, -5.57, Z=-5.48, -2.12, P<0.05). (3) Postoperative complications and treatment. There were 5 cases of the experiment group and 7 cases of the control group with postoperative complications, showing no significant difference between the two groups ( χ2=0.37, P>0.05). The patients with postoperative complications were improved after symptomatic treatment. Conclusion:Compared with injection of carbon nanoparticle tracer 24 hours before surgical resection, injection of carbon nanoparticle tracer 24 hours before nCRT can improve the acquisition of lymph nodes in AEG treated by nCRT combined with surgical resection.
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Objective To explore the clinical value of indocyanine green (ICG) fluorescence navigation combined with carbon nanoparticles (CNP) in sentinel lymph node biopsy (SLNB) for patients with early breast cancer. Methods A total of 294 early breast cancer patients with axillary node negative in Department of Breast Surgery, Foshan Hospital Affiliated to Sun Yat-Sen University from June 2013 to April 2016 were retrospectively analyzed. Of the patients, 149 cases underwent SLNB with ICG combined with CNP (combination group), while 145 cases underwent SLNB with methylene blue alone (MB group). If the intraoperative pathology results of sentinel lymph nodes (SLNs) were negative, axillary lymph node dissection (ALND) was avoided. The SLNs detection rate, detection number, metastatic SLNs detection rate in SLNB were compared between two groups. The influence of age and body mass index (BMI) on SLNs detection rate was also analyzed. Results In the combination group, subcutaneous lymphatic channels were successfully visualized in 145 patients, and the detection rate was 97.3％(145/149). The fluorescence of SLNs was successfully detected in 143 patients, and the detection rate was 95.9％(143/149). The detection rate of SLNs was higher in the combination group than that of methylene dye alone group (97.9％vs. 91.0％,χ2=6.902,P<0.05). The average number of detected SLNs was higher in the combination group than that of methylene dye alone group (4.5±1.6 vs. 3.2±1.5,t=4.476,P<0.05). Fifty-eight metastatic SLNs were found in 715 SLNs in the combination group (8.1％), and 26 in 544 SLNs in MB group (4.7％). The detection rate was significantly higher in the combination group than that of methylene dye alone group (χ2=13.714,P<0.01). Age and BMI showed no influence on the detection rate and accuracy of SLNB in two groups (P>0.05). Conclusion The combined tracing of ICG fluorescence and carbon nanoparticles for SLNB has showed a better stability and operability in patients with early breast cancer, which is recommended to be a new SLNB method.
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Objective To investigate the application value of carbon nanoparticle lymphatic tracer in Da Vinci robot-assisted radical gastrectomy for advanced gastric cancer.Methods The clinical data of 63 advanced gastric cancer patients in Gansu Provincal Hospital in 2016 were analyzed retrospectively.Patients were divided into three groups:robot with carbon nanoparticle group,laprascopy with carbon nanoparticle group and laprascopy surgury group.Numbers of harvested lymph were compared between the 3 groups,and the perioperative complications were evaluated.Results The number of harvested lymph nodes in carbon nanoparticle group (31.5 ± 3.8) was significantly higher than those of laprascopy joint carbon nanoparticle group (25.3 ± 2.6),F =5.5,P =0.03 and laprascopy group (21.1 ± 2.7),F =6.1,P=0.01.The number of blackdyed harvested lymph node was 481 (76.2％) and the metastasis rate of black-dyed lymph node was 26.8％ in robot joint carbon nanoparticle group.There was no significant difference in the metastasis rate of black-dyed between the robot joint carbon nanoparticle group and laprascopy joint carbon nanoparticle group,x2 =0.17,P =0.22.Condusions The application of diluted carbon nanoparticle lymphatic tracer helps in the dissection of lymph nodes in Da Vinci robot-assisted radical gastrectomy for advanced gastric cancer.
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Objective To explore the clinical effect of carbon nanoparticle in the axillary sentinel lymph node tracer of breast cancer.Methods Fifty-seven patients with breast cancer underwent lymphatic tracing with carbon nanoparticle.The carbon nanoparticle suspension was subcutaneously injected around the areola (points at 4 o'clock) and tumor surface skin at 30 min before operation.The first lymph nodes blacked were named sentinel lymph node.Then performed modified radical mastectomy,observing the application value of carbon nanoparticle.Results The detection rate of sentinel lymph node was 98.2％ (56/57).The correct,sensitive and false negative rates were 98.2％(55/56),95.2％(20/21) and 4.8％(1/21),respectively.The false positive rate was 0.Conclusions The carbon nanoparticle suspension injection subcutaneously around areola in sentinel lymph node biopsy is helpful for accurately evaluating the axillary lymph node condition.Being simple to operate,accurate positioning,dyeing time and is worth popularizing.
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Objective To evaluate the clinical application value of local injections of carbon nanoparticle in gastrectomy of stomach neoplasms.Methods Forty cases of stomach neoplasms with local injections of carbon nanoparticle in gastrectomy of stomach neoplasms were as experimental group,and 40 cases of stomach neoplasms with conventional gastrectomy of stomach neoplasms were as control group.The number of removed tiny lymph node and transferred tiny lymph node was compared.Results There was significant difference in the average number of removed tiny lymph node N1,N2,N3 between experimental group and control group (5.120 ± 0.455 vs.2.900 ± 0.245,3.890 ± 0.367 vs.1.750 ± 0.256,1.790 ± 0.224 vs.0.590 ± 0.054)(P ＜ 0.01).There was significant difference in the average number of transferred tiny lymph node N1,N2,N3 between experimental group and control group (1.090 ±0.087 vs.0.430 ± 0.044,0.550 ± 0.052 vs.0.340 ± 0.027,0.410 ± 0.044 vs.0.130 ± 0.013)(P ＜ 0.05).There was no significant difference in postoperative complications,mortality and length of hospital stay(P＞ 0.05).Conclusion Carbon nanoparticle in gastrectomy of stomach neoplasms is a simple,safe,easy method,and it has certain supplementary role in conventional gastrectomy of stomach neoplasms.
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Objective To investigate the clinical application and curative effect of Carbon Nano-particles in curative resection of mid-low rectal cancer .Methods 26 patients with mid-low rectal cancer were divided equally into carbon nano-particle group and routine group .The labeling group were injected with carbon nano-particles 20~24 hours before operation and treated with TME laparoscopic radical resection .The data of lymph nodes detected in the two groups were compared .Results (1)Total number of lymph nodes detected in the labeling group was higher than that of the routine group (287 vs .124 ,P0 .05) .Con-clusion Adoption of carbon nano-particle in curative resection of rectal cancer can increase the number of lymph nodes detected ,re-veal more accurately the metastasis situation of lymph nodes ,facilitate the resection of lymph nodes and rectal cancer during the op-eration ,and provide guidance for postoperative clinical staging and treatment .