Clinical Study On The Application Of Nano-carbon To Improve The Accuracy Of Lymph Node Staging In Early Gastric Cancer

Objective:To explore the clinical value of using nano-carbon suspension injection(CNSI)to improve the accuracy of lymph node staging in early gastric cancer.Methods:A total of 108 patients with early gastric cancer admitted to the Fourth Hospital of Hebei Medical University from January 2016 to January 2019 were enrolled.The random number table method was used to divide it into a nano-carbon group and a control group,54 cases in each group.The nano-carbon group was injected with CNSI under endoscopy before surgery,and the control group was not injected with CNSI.All patients underwent D2 radical surgery for gastric cancer.The total number of lymph nodes detected,the total number of black lymph nodes,the total number of small lymph nodes(diameter <2 mm),the time of lymph node detection,the lymph node black staining rate,lymph node metastasis rate,black lymph node metastasis rate,lymph node detection time,and postoperative complication rate were recorded.And lymph node staging.Results:1.There were no significant differences in age,gender,tumor location,cTNM staging,histological type,degree of differentiation,and surgical range between the two groups(P>0.05).2.The total number of lymph nodes detected: 2359 in the nano-carbon group and 1670 in the control group.The number of lymph nodes detected was: nanocarbon group(43.68±18.25)and control group(30.92±10.78).The difference between the two groups(t=4.383,P<0.001)was statistically significant.A total of 1259 black-stained lymph nodes were detected in the nano-carbon group,and the black-stained rate of lymph nodes was 53.12%(1253/2359).3.The number of micro-lymph nodes detected was(6.50±2.87)in the nano-carbon group and(2.17±1.45)in the control group.The difference(t=9.805,P=0.000)was statistically significant.4.Lymph node metastasis rate: The lymph node metastasis rate of the nano-carbon group was 0.805%(19/2359),which was significantly higher than that of the control group(0.179%(3/1670)).The difference(?2=7.051,P=0.008)was statistically significant.Lymph node metastasis rate in the nano-carbon group: the black-stained lymph node metastasis rate was 1.36%(17/1253)higher than 0.18%(2/1106)unstained lymph nodes,and the difference(?2=10.168,P=0.001)was statistically significant.5.Lymph node staging: 44 cases of pN0 in nano carbon group,9 cases of pN1,and 1 case of pN2.There were 52 cases of pN0 and 2 cases of pN1 in the control group.The difference of pN between the two groups was statistically significant(?2=6.00,P=0.014).6.Lymph node detection time: the lymph node of the nano-carbon group was(23.56±1.89)min;the control group(35.83±2.28)min,the difference(t=-30.271,P=0.000)was statistically significant.7.Complications: There was no significant difference in the incidence of complications between hemorrhagic,pulmonary infection,lymphatic fistula and postoperative anastomotic leakage in the nano-carbon group and the control group(P>0.05).Conclusion:In early gastric cancer surgery,preoperative application of nano-carbon can increase the number of lymph node dissection,the number of micro-lymph node dissection,increase the number of metastatic lymph node dissection,thereby improving the accuracy of postoperative lymph node staging,and the safety is higher.