Efficiency Of Nanocarbon Suspension In Dissection And Treatment Of Tongue Squamous Carcinoma Cervical Lymph Node At Stage CN₀

Objective: To evaluate the security and efficiency of nanocarbon suspension in dissection of tongue squamous carcinoma cervical lymph node at stage c N₀ by tracing the cervical lymph node of the patients with tongue squamous carcinoma at stage c N₀ and by comparing it with traditional treatment results of cervical lymph node, and to discuss the relations between black staining lymph gland and cancer cell metastasis,with the aim to provide clinical evidence for the selection of the surgical method of dissecting tongue squamous carcinoma cervical lymph node as well as for their postoperative comprehensive treatment.Materials and methods: Retrospective case-control study was adopted.Altogether 43 cases of c N₀ tongue squamous carcinoma patients who were hospitalized in the Octolaryngology Head and Neck Surgery Department and Department of Stomatology of Loudi City Central Hospital of University of South China during January, 2013 to March,2016 and who satisfied the selecting standards were chosen. The patients were divided into nanocarbon tracing group?23 cases? and conventional operating group?20 cases? randomly according to the sequence of hospitalization. 23 cases in nanocarbon tracing group received tongue cancer radical operation with the same principle as the conventional operating group one day after they were injected nanocarbon, while the20 cases in the conventional group were not injected nanocarbon. After the operation, some specially-assigned persons were responsible for looking for all lymph glands in fresh specimen, which were delivered to pathology department for conventional HE dyeing and were responsible for checking the transferring condition. After the operation,the total number of the dissected lymph glands of both groups, the black-staining lymph glands of nanocarbon injection group were calculated and compared; the black-staining and no blacking staining lymph glands were verified the cancermetastasis by pathology; and the numbers, the metastatic rate as well as the micrometastasis of lymph node dissection of both groups were compared. The results were analyzed statistically with SPSS19.0 statistical software and the differences had statistical significance?P<0.05?.Results: Altogether 472 lymph glands were obtained from 23 cases of nanocarbon tracing group, with the average dissection number of20.73±6.92?the most of 32 and the least of 6?. Altogether 234 lymph glands were obtained from 20 cases of the conventional operating group, with the average dissection number of 12.06±4.58?the most of 24 and the least of 5?. Obviously, the average dissection number of the nanocarbon tracing group was higher than that of the control group. The differences between both groups had statistical significance?P<0.05?.Among the 472 lymph glands dissected from the nanocarbon tracing group, there are altogether 331 black-staining lymph glands with the staining rate of 70.1%?black-staining lymph glands/total dissected lymph glands?, which showed that the black staining efficacy was obvious.In the nanocarbon tracing group,altogether 472 lymph glands were cleared, among which 46 transferred, with the positive rate of 9.7%;while in the conventional operating group, altogether 234 lymph glands were cleared, among which 22 transferred, with the positive rate of 9.4%.The positive rates of both groups were close to one another and there was no statistical significance?P>0.05?.In the nanocarbon tracing group,altogether black-staining lymph glands were obtained, among which 33 transferred, with the 331 positive rate of 10% and 141 without black-staining lymph glands were obtained,among which 13 transferred, with the positive rate of 9.2%. The positive rate of black-staining lymph gland metastasis of the tracing group 10%was not higher than that 9.2% of those without black staining and that9.4% of the conventional operating group.Among the 23 case of the nanocarbon tracing group, altogether 13 cases occurred lymphatic metastasis, with the metastasis rate of 56.6%?13/23?; while among the 20 cases of the conventional operating group,10 cases occurred lymphatic metastasis, with the metastasis rate of50%?10/20?. The metastasis rate of both groups were close to one another and the difference had no statistical significance?P>0.05?.Among the 472 black-staining lymph glands dissected from the nanocarbon tracing group, 41 were tiny lymph nodes with the diameter of about 1-2mm, which were hard to be identified and detected without staining. Among these 41 tiny lymph glands, 7 were verified transferred through pathological examination, with the positive rate of 17.1%. After detection, 5 cases of the 23 cases of nanocarbon tracing group had tiny lymph gland metastasis, with the metastasis rate of 21.7%; while the metastasis number of the conventional group was comparatively less.Only 1 patient was found micrometastasis, with the micrometastasis rate of 5%.Conclusions:1.Nanometer tracer technique could develop the draining lymph node in the area of tongue squamous carcinoma with better staining effect,which had certain guiding function in dissecting tongue squamous carcinoma lymphonodi cervicales. It also could make the metastatic lymph nodes which belong to the area outside the standard radical easy to differentiate. Therefore, it has higher clinical value.2.Nanocarbon could show clearly cervical lymph node. It could not be infected with the peripheral tissues. After the operation, it could help physicians from pathology department increase lymph gland detection rate, especially for detection of tiny lymph glands. It could help obtain correct pathological stage, which is of great significance for post-operation comprehensive treatment.3. Nanocarbon could trace lymph gland; however, it could not be regarded as the basis of determining whether lymph gland has metastasized.