Application Of Lymph Node Labeling With Carbon Nanoparticles In Laparoscopic Colorectal Cancer Surgery And Its Clinical Significance Of Detection Of Sentinel Lymph Node Biopsy

Objective To investigate the value of lymph node labeling with carbon nanoparticles in laparoscopic colorectal cancer surgery and its clinical significance of detection of sentinel lymph node biopsy.Methods Retrospectively analyze the clinical data of 53 patients undergone laparoscopic radical colorectal surgeries in our department from Mar.2014 to Jul.2014. Among these patients, carbon nanoparticles were injected into the periphery of the tumor under colonoscopy in 26 patients 1 days before the operation (the nanoparticle group), Sentinel lymph nodes (SLNs) were defined as nodes that were black-dyed by carbon nanoparticles near the tumor. Pathology confirmed whether lymph nodes have cancer metastases and the SLNs accuracy. while 27 patients received operation directly (the control group). The number of cleared lymph nodes, tiny lymph nodes (<5mm), dyed lymph nodes, and lymph node metastatic rate were compared between two groups.Results The two groups had no statistical difference in basic characteristics; 434 and 340 lymph nodes were dissected in the nanoparticle group and control group respectively. The average number of cleared lymph nodes(16.7±3.23) in the nanoparticle group was significantly higher than that of the control group(12.6±2.31) (P<0.001). Besides, both the average number and ratio of cleared tiny lymph nodes in the nanoparticle group were remarkably higher than those of the control group(P<0.001). Moreover, the ratio of less than 12 detected lymph nodes in the nanoparticle group was markedly lower than that of the control group (0vs33.3%, P=0.001). There was no statistical difference in lymph node metastatic rate between the two groups (P=0.693) SLNs were detected in 26 of 26 Patients with a successful detection rate of 100%.The number of SLNs ranged from 1 to 4,with a meanvalue of 2.5±0.96.By the conventional HE staining,16 SLNs were Positive,38.5%(10/26)of colorectal carcinoma Patients were with sentinel lymph node metastasis. Sensitivity, accuracy and pseudo negative of the SLN biopsy were 76.9%,88.5%, 23.1%.Conclusion Application of lymph node labeling with carbon nanoparticles in laparoscopic colorectal cancer surgery could instruct lymph nodes dissection, improve lymph node detection rate, reduce tumor residual, improve the accuracy of pathological staging, and guide the postoperative adjuvant therapy. The SLN concept is validated in CRC. Nano carbon positioning biopsy colorectal SLNS could predict the transfer of regional lymph node status and has a certain potential value.