Abstract: Objective:To explore the clinical application value of carbon nanoparticles labeled lymph node staining combined with artery approach in radical resection of sigmoid colon cancer.
Methods:The retrospective cohort study was conducted. The clinicopathological data of 40 patients with sigmoid colon cancer who were admitted to the Tumor Hospital of Zhengzhou University (Henan Cancer Hospital) from December 2015 to June 2016 were collected. Among 40 patients undergoing radical resection of sigmoid colon cancer, 20 using nanometer carbon lymph node staining combined with artery approach and 20 using the traditional lymph node sorting were respectively allocated into the observation group and control group. Observation indicators: (1) detection of the lymph node and pathological examination; (2) followup situations. Followup using outpatient examination and telephone interview was performed to detect adjuvant chemotherapy, tumor recurrence or metastasis and surgeryrelated complications up to June, 2017. Measurement data with normal distribution were represented as ±s, and comparisons between groups were evaluated with the t test. Comparisons of count data were analyzed using the chisquare test. The comparisons of ordinal data were analyzed using the nonparametric test.
Results:(1) Detection of the lymph node and pathological examination: 40 patients underwent successful radical resection of sigmoid colon cancer. The lymph node sorting time, total and average numbers of lymph node sorting, total and average numbers of lymph node with diameter < 5 mm, cases with lymph node number <12 and numbers of the first, second and third stations lymph nodes were respectively (13.1±2.4)minutes, 522, 28.0±7.0, 152, 8.6±2.5, 0, 13.7±3.6, 9.5±2.5, 4.7±1.2 in the observation group and (18.4±3.5)minutes, 239, 13.0±3.0, 64, 3.9±1.7, 6, 6.1±1.6, 6.6±2.2, 2.5±1.0 in the control group, with statistically significant differences between groups (t=14.562, 24.872, 19.256, X²=4.902, t=14.368, 10.026, 8.210, P<0.05). The total number of positive lymph node, positive rate of lymph node, metastasis rate of patients, total and average numbers of positive lymph node with diameter <5 mm and numbers of the first, second and third stations positive lymph nodes were respectively 82, 0.22%±0.13%, 17/20, 51, 3.9±1.9, 4.2±1.8, 1.9±0.6, 2.3±1.2 in the observation group and 43, 0.48%±0.18%, 7/20, 38, 2.7±1.5, 2.1±0.6, 2.6±0.7, 1.4±0.5 in the control group, showing no statistically significant difference in the positive rate of lymph node and number of the third station positive lymph nodes between groups (t=1.462, 1.759, P>0.05). There were statistically significant differences in the metastasis rate of patients, average number of positive lymph nodes with diameter <5 mm and numbers of the first and second stations positive lymph nodes between groups (X²=10.417, t=7.264, 4.682, 3.410, P<0.05). (2) Followup situations: 40 patients were followed up for 12-18 months, with a median time of 16 months. Eighteen and 10 patients in the observation group and control group received postoperative adjuvant chemotherapy, showing a statistically significant difference between groups (X²=5.833, P<0.05). Tumor recurrence or metastasis was respectively detected in 0 and 2 patients (1 with local recurrence and 1 with liver metastasis) in the observation group and control group, with no statistically significant difference between groups (X²=2.105, P>0.05). During the followup, there was no surgeryrelated complication.
Conclusion:The carbon nanoparticles labeled lymph node staining combined with artery approach in radical resection of sigmoid colon cancer can increase the sorting rate and number of lymph node, and improve the accuracy of postoperative pathological staging.