| Objective:Discuss application value of sentinel lymph node in operation of endometrial cancer through carbon nanoparticles tracing sentinel lymph node of endometrial cancer.Methods:1. Collect patients accepting operation of endometrial cancer in the Third Affiliated Hospital of Kunming Medical University from September 23,2008 to June 30,2014; screen clinical pathological features, surgical method, postoperative complications, postoperative treatment and others of patients with clinical stage I; compare influence of different surgical methods on relapsing of patients with low-risk endometrial cancer at early phase.2.74 patients have accepted operation of endometrial cancer in the Third Affiliated Hospital of Kunming Medical University from June 2014 to December 2015; adopt cervical multi-point injection of tracer before operation and corpus multi-point injection of tracer during operation so as to recognize black staining lymph node, and mark position and numbers for sentinel lymph node. Do routine pathological examination after operation.3. Statistical treatmentSPSS 17.0 software is used to carry out statistical treatment for statistical analysis; Kaplan-Meier method is used for survival analysis; Cox regression analysis is used for multi-factor analysis; enumeration data is inspected by χ2;P<0.05 shows that difference has statistical significant.Results:1. Sweeping pelvic lymph node for patients with endometrial adenocarcinoma in stage I do not improve the 5-year survival rate of patients, but postoperative complications are apparently higher than non-sweeping group;2.22 cases in 74 cases show no black staining lymph node, among them,7 cases carry out cervical injection, accounting for 20%(7/35); 15 cases carry out corpus injection, accounting for 38.5%(15/39); 185 SLN have been checked out in the 52 cases; total detection rate of carbon nanoparticles tracer is 70.5%; 3.5 SLN (1-8) have been checked out in each case on average;3. Distribution of SLN:a. cervical injection method:external iliac 47.9%(46/96); obturator 30.2%(29/96); common iliac 11.5%(11/96); internal iliac 3.13%(3/96); abdomen 6.25%(6/96); parametrium 1.04%(1/96); b. corpus injection method: external iliac48.3%(43/89); obturator31.5%(28/89); common iliac 8.99%(8/89); internal iliac 4.49%(4/89); abdomen6.74%(6/89);4. Detect 35 cases of SLN (145) on both sides of pelvic cavity; detect 17 cases of SLN (45) on one side. In cervical injection, SLN located in pelvic cavity accounts for 92.8%, meanwhile, SLN located in pelvic cavity and side of abdominal aortic sidewall accounts for 3.6%; SLN only located in side of abdominal aortic sidewall accounts for 3.6%; in corpus injection,87.5%of SLN is located in pelvic cavity, meanwhile,12.5% of SLN is located in pelvic cavity and side of abdominal aortic sidewall (P<0.05, with statistical significance).5. Detect transfer of pelvic and abdominal lymph nodes of 8 patients in routine pathological examination, among them, positive SLN is found in 4 cases, including 2 cases of positive SLN in obturator,1 case of positive SLN in external iliac; another 4 cases of positive in pelvic and abdominal lymph nodes; but SLN is not detected. Sensitivity for detecting SLN is 50%(4/8); specificity is 100.0%(70/70); veracity is 94.6%(70/74); negative predictive value is 94.3%(66/70).Conclusions:1. Carbon nanoparticles has the advantages of good addicted lymph nodes, clear display of lymph nodes and lymphatic vessels, zero radioactivity to the experimenter and surrounding environment. As a new kind of specific lymph node tracer, it is significantly better than the past biological and radioactive tracing method;2. Detection rate of cervical and corpus injection tracer for SLN has no statistical differences;3. SLN positive and pelvic and abdominal lymph nodes have consistency;4. Recognition of SLN during operation has feasibility, and can provide theoretical foundation for narrowing scope of operation in low-risk endometrial cancer at early stage and lowering operative complications. |
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