新型纳米碳对行腹腔镜膀胱癌根治术患者盆腔淋巴结的示踪效果及其安全性评价

doi:10.13481/j.1671-587x.20190319

吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (03): 582-586.doi: 10.13481/j.1671-587x.20190319

• 临床研究 • 上一篇

新型纳米碳对行腹腔镜膀胱癌根治术患者盆腔淋巴结的示踪效果及其安全性评价

马佳男¹, 高宝山², 肖平³, 张永瑞², 吴大威², 安伟²

1. 吉林大学第一医院转化医学院, 吉林长春 130021;
2. 吉林大学第一医院泌尿外科, 吉林长春 130021;
3. 吉林大学第一医院第一手术室, 吉林长春 130021

收稿日期:2018-07-27 发布日期:2019-06-05
通讯作者: 安伟,教授,硕士研究生导师(Tel:0431-81875833,E-mail:anwei64@163.com) E-mail:anwei64@163.com
作者简介:马佳男(1992-),女,吉林省长春市人,在读医学博士,主要从事肿瘤免疫学和移植免疫学方面的研究。
基金资助:
国家自然科学基金资助课题（81501381）；吉林大学第一临床医院培育基金资助课题（LCPYJJ2017001）

Tracing effect of new nano-carbon onpelvic lymph nodes of patients during laparoscopic radical cystectomy and its safety evaluation

MA Jianan¹, GAO Baoshan², XIAO Ping³, ZHANG Yongrui², WU Dawei², AN Wei²

1. College of Translational Medical Sciences, First Hospital, Jilin University, Changchun 130021, China;
2. Department of Urinary Surgery, First Hospital, Jilin University, Changchun 130021, China;
3. First Operating Room, First Hospital, Jilin University, Changchun 130021, China

Received:2018-07-27 Published:2019-06-05

摘要/Abstract

摘要： 目的：探讨新型纳米碳（卡纳琳）在腹腔镜膀胱癌根治术（RC）中对患者盆腔淋巴结的示踪效果，阐明其在精准外科治疗中应用的意义。方法：依据术前是否使用卡纳琳将44例行腹腔镜RC患者分为示踪剂组（n=22）和对照组（n=22），2组患者均行腹腔镜下RC联合标准盆腔淋巴结清扫术（LND）。收集并比较2组患者有效性评价指标和安全性评价指标。有效性评价指标包括示踪剂组患者术中淋巴结黑染情况、检出淋巴结总数、淋巴结黑染数、淋巴结黑染率、阳性淋巴结数和手术时间；安全性评价指标包括术中出血量和围手术期相关并发症发生率。结果：示踪剂组患者淋巴结染色效果确切，围手术期未见示踪剂相关不良反应及并发症。与对照组比较，示踪剂组患者淋巴结清除率和检出率均升高（P<0.01），各例患者淋巴结黑染率均高于50%，甚至可达85%；2组患者阳性淋巴结检出数、手术时间、出血量和围手术期相关并发症发生率比较差异均无统计学意义（P>0.05）。结论：在腹腔镜RC中，应用卡纳琳进行盆腔淋巴结示踪安全且无不良反应，卡纳琳对提高淋巴结的术中清扫率和术后病理检出率均具有重要意义。

关键词: 淋巴示踪剂, 纳米碳混悬注射液, 膀胱癌根治术, 淋巴结清扫

Abstract: Objective:To investigate the tracing effect of new nano-carbon(Kanalin)on the pelvic lymph nodes of the patients with bladder cancer during the laparoscopic radical cystectomy(RC), and to explain the significance of its application in the precision surgical treatment. Methods:A total of 44 patients with bladder cancer who underwent RC were divided into tracer group(n=22) and control group (n=22) according to whether Kanalin was used before operation or not. The laparoscopic RC combined with standard pelvic lymph node dissection(LND) was performed in the patients in two groups. The effectiveness evaluation indexes and safety evaluation indexes of the patients in two groups were collected and compared. The effectiveness evaluation indexes included black staining situation of lymph nodes during operation,the number of detected lymph nodes,the black staining rate of lymph nodes,the number of positive lymph nodes, and operation time. The safety evaluation indexes included the blood loss and the incidences of perioperative complications. Results:The black staining effect of lymph nodes of the patients in tracer group was definite and there were no tracer-related side effects and complications during the perioperative period. Compared with control group, the clearance rate and detection rate of lymph nodes of the patients in tracer group were increased (P<0.01). The black staining rate of lymph nodes of each case was higher than 50%, even up to 85%. There were no significant differences in the number of positive lymph nodes,the operation time, the blood loss and the perioperative complication rates of the patients between two groups(P>0.05). Conclusion:During the laparoscopic RC, the application of Kanalin for pelvic lymph node tracing is safe, without toxic and side effects;Kanalin is helpful for increasing the intraoperative clearance rates and postoperative pathological detection rates of lymph nodes.

Key words: lymphatic tracer, carbon nanoparticle suspension injection, radical cystectomy, lymph node dissection

中图分类号:

R737.14

马佳男, 高宝山, 肖平, 张永瑞, 吴大威, 安伟. 新型纳米碳对行腹腔镜膀胱癌根治术患者盆腔淋巴结的示踪效果及其安全性评价[J]. 吉林大学学报(医学版), 2019, 45(03): 582-586.

MA Jianan, GAO Baoshan, XIAO Ping, ZHANG Yongrui, WU Dawei, AN Wei. Tracing effect of new nano-carbon onpelvic lymph nodes of patients during laparoscopic radical cystectomy and its safety evaluation[J]. Journal of Jilin University(Medicine Edition), 2019, 45(03): 582-586.

参考文献

[1] RYAN C J, SMITH M R,DEBONO J S, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy-NEJM[J]. N Engl J Med, 2013, 368(2):138-148.
[2] WITJES J A, COMPÉRAT E, COWAN N C, et al. EAU guidelines on muscle-invasive and metastatic bladder cancer:summary of the 2013 guidelines[J]. Eur Urol, 2014, 65(4):778-792.
[3] 袁绍峰, 孔祥东, 卢江昆, 等. 纳米碳示踪剂在甲状腺癌中央组淋巴结清扫中的应用及临床意义[J]. 中国现代普通外科进展, 2017, 20(7):527-530.
[4] 王雷, 陈旭, 赵成功, 等. 纳米碳在乳腺癌前哨淋巴结活检中的应用[J]. 中国肿瘤临床与康复, 2017, 24(1):49-51.
[5] 贾荣保, 姜立新, 姚增武, 等. 纳米碳示踪剂在腹腔镜胃癌淋巴结清扫术中的临床研究[J]. 腹腔镜外科杂志, 2018, 23(1):36-39.
[6] 胡伟, 张桢, 沈丰, 等. 纳米碳示踪技术在胰腺癌根治术中的应用探讨[J]. 中华普外科手术学杂志:电子版, 2018, 12(5):424-427.
[7] STENZL A, NAGELE U, KUCZYK M, et al. Cystectomy-technical considerations in male and female patients[J]. Eau Update, 2005, 3(3):138-146.
[8] VAN POPPEL H, SORGELOOSE T. Radical cystectomy with or without urethrectomy?[J]. Crit Rev Oncol Hematol, 2003, 47(2):141-145.
[9] LIEDBERG F, CHEBIL G, DAVIDSSON T, et al. Intraoperative sentinel node detection improves nodal staging in invasive bladder cancer[J]. J Urol, 2006, 175(1):84-88;discussion 88-89.
[10] 白宇,谢立平.膀胱癌淋巴结清扫术的研究进展[J].国外医学:泌尿系统分册, 2005(4):433-436.
[11] FAYSAL A Y,WASSIM K. Experience of laparoscopic radical cystectomy and sigmoid colon orthotopic neobladder reconstruction for invasive bladder cancer:Report of 18 cases[J].Chin J Endourol, 2013, 7(3):188-192.
[12] MAY M, HERRMANN E, BOLENZ C, et al. Association between the number of dissected lymph nodes during pelvic lymphadenectomy and cancer-specific survival in patients with lymph node-negative urothelial carcinoma of the bladder undergoing radical cystectomy[J]. Ann Surg Oncol, 2011, 18(7):2018-2025.
[13] 张东方, 牛家峰, 侯蕾蕾. 常用淋巴结示踪剂研究进展[J]. 菏泽医学专科学校学报, 2015, 27(3):82-85.
[14] 孙荣能, 赵迎春, 曹晓丽,等. 纳米碳在甲状腺微小乳头状癌手术中对甲状旁腺及喉返神经的保护作用研究[J]. 中华普外科手术学杂志:电子版, 2018, 12(4):302-305.
[15] 刘成彪, 崔世昌, 王维山,等. 纳米碳示踪技术在胰头癌行全胰腺系膜切除的胰十二指肠切除中的应用[J]. 解放军医学院学报, 2018, 39(3):185-188,195.
[16] 张亚, 何丽萍. 纳米炭混悬注射液示踪前哨淋巴结对宫颈癌淋巴结清扫及病理结果的影响[J]. 实用癌症杂志, 2017, 32(8):1380-1382.
[17] 兰军良,许其威,董晓勇. 纳米碳混悬液在胆囊癌淋巴结清扫中的应用[J].中国医药指南, 2015,27(3):110-112.
[18] 吕春晖, 陈海珍, 沈晓卉,等. 纳米碳在双甲全切加双侧中央区淋巴结清扫术中的临床应用[J]. 中华内分泌外科杂志, 2017, 11(1):34-39.
[19] 王敏, 姚峰. 应用纳米炭混悬液行乳腺癌前哨淋巴结活检的临床研究[J]. 中华实用诊断与治疗杂志, 2018, 32(4):358-361.
[20] 徐弘扬, 何晓光, 杨曦, 等. 纳米碳在头颈部恶性肿瘤中的临床应用现况研究[J]. 中国医学文摘:耳鼻咽喉科学, 2017, 32(2):102-105.
[21] 刘逸尘,李席如,杜晓辉,等.术前中性粒细胞/淋巴细胞及血小板/淋巴细胞比值对直肠癌根治术后手术部位感染的预测价值[J].解放军医学杂志,2019,44(3):243-247.
[22] 庞艳彬,赵松颖,薛华,等.骨髓增生异常综合征患者淋巴细胞绝对值计数与地西他滨治疗反应的关系[J].解放军医学杂志,2018,43(3):239-243.

新型纳米碳对行腹腔镜膀胱癌根治术患者盆腔淋巴结的示踪效果及其安全性评价

Tracing effect of new nano-carbon onpelvic lymph nodes of patients during laparoscopic radical cystectomy and its safety evaluation

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 5

Metrics

本文评价

推荐阅读 0

[1]	范励雯, 付彤, 古林, 吴迪, 贾泓瑶, 宋东. 副乳腺癌1例报告及文献复习[J]. 吉林大学学报(医学版), 2018, 44(02): 412-415.
[2]	李理, 王瑶琪, 孟宪瑛, 张强, 陈光, 李群, 逄仁柱, 杨帅, 付京. 纳米碳标记的淋巴导向示踪技术在甲状腺全切术中应用的研究进展[J]. 吉林大学学报(医学版), 2015, 41(05): 1095-1098.
[3]	林星宇,杨志广,张鹏,邵国光. 全胸腔镜肺叶切除与开胸肺叶切除治疗老年肺癌的疗效比较[J]. 吉林大学学报(医学版), 2014, 40(06): 1275-1279.
[4]	佟倜\|曹彬. 胸中上段食管癌三野淋巴结清扫及二野淋巴结清扫临床疗效比较[J]. J4, 2012, 38(4): 792-795.
[5]	徐景伟\|赵慧\|王振宇\|明鹏\|王琢. 不同分组间乳腺癌患者腋窝淋巴结转移的关联性分析[J]. J4, 2011, 37(5): 923-926.