纳米炭标记淋巴结在中西医结合治疗直肠癌中的应用探究.pdfVIP

提 要 目的：研究应用纳米炭标记直肠癌淋巴结的可行性、准确性，观察纳米炭示踪的 淋巴引流途径；探讨局部注射纳米炭对直肠癌根治术的改进作用；通过集中分析前哨 淋巴结来了解是否可以准确预测局部淋巴结的转移情况；探讨纳米炭吸附抗癌剂保留 灌肠对直肠癌患者行淋巴靶向治疗的可行性。方法：将山东大学第二医院2007年4 月至2008年3月间收治的38例直肠癌患者随机分为两组。实验组于术中注射纳米炭 行前哨淋巴结(SLN)标记及淋巴结示踪，术后检查切除标本各站淋巴结数目及分布情 况，并用常规HE染色及连续切片检测法进行微转移检测，所得结果与对照组比较。 结果：实验组病人均成功定位出前哨淋巴结，共检出前哨淋巴结41枚，平均每例2.16 枚；SLN定位活检敏感性为88.9％，准确性为84.2％，假阴性率为11.1％；两组平 均每例清除的淋巴结数目和每例第二、三站清除的淋巴结数目，实验组均高于对照组 （p0.05）。结论：应用纳米炭示踪对直肠癌SLN进行定位活检安全、可行；能够发 现直肠癌的异常淋巴引流，对手术切除范围有一定的指导意义；能明显提高淋巴结清 除数量；集中对SLN进行检查分析可以提高肿瘤分期的准确性；初步证实了纳米炭辅 助行中药保留灌肠干预直肠癌淋巴转移技术开展的可行性。 关键词 直肠癌；纳米炭混悬液；前哨淋巴结；微转移 The Clinical Study of Carbon Nanoparticles Mapping Lymph Node in TCM and Wesetern Medicine Combined Treatment of Rectal Carcinoma Speciality：Surgery of TCM Author ：Li Tao Tutor：Prof.Ding ke Abstract Objective: To identify intraoperative lymph node mapping by injection carbon nanoparticles is feasible, precise,and ascendant. To discuss the improving function of locally injection carbon nanoparticles in rectal carcinoma operations, and research the sentinel lymph node status reflects the regional node status and focused analysis of the sentinel lymph node improve staging.To identify carbon nanoparticles assisted retention-enema with Chinese medicine targeted therapy rectal cancer lymphatic metastasis is feasible.Methods: These 38 patients with rectal carcinoma from Aptil ,2007 to March,2008,were randomized into two groups,19 cases with local injection of 1ml(50mg) carbon nanoparticles suspension injection around the peripherd of the neoplasm(CNP group),another 19 case with standard lymphadenectomy only (control group).To detect and re