Clinical Study On The Application Value Of Nano-carbon In The Tracing Of Sentinel Lymph Nodes In Endometrial Carcinoma

Objectives:Applying nano-carbon to patients with endometrial carcinoma performed the Sentinel Lymph Node(SLN)mapping technology,evaluates the application value of nano-carbon in the tracing of SLN in endometrial carcinoma,in order to achieve the expectation that making individualized surgical procedures by the nature of SLN,thereby reducing the complications comprehensive staging surgery.Methods:37 patients with endometrial carcinoma admitted to the gynecology department of Affiliated Hospital of Hebei University from December 1,2017 to December 31,2018,were treated with"two-point method"(3 points,9 points at the cervix)after general anesthesia.The same amount of nano-carbon was injected into the cervix,a total of 1.0 ml,and the lymph nodes that were black-stained within 30 minutes were identified as SLN.None Sentinel Lymph Node(NSLN)was used for more than 30 minutes.All patients underwent the laparoscopic uterus+bilateral attachment+pelvic lymphadenectomy+/-abdominal aortic lymphadenectomy.Excised SLN and NSLN were sent for pathology.SLNs that hematoxylin-eosin(HE)staining for pathological examination showde no metastasis underwent immunohistochemistry(IHC),through the cytokeratin(CK)pathological micrometastase detection to rule out lymph node micrometastasis(low volume metastasis of the tumor).Data analysis of postoperative pathological results was performed using SPSS24.0 statistical software,and the identification of SLN(total detection rate,bilateral detection rate,sensitivity,negative prediction value)was statistically described.Measurement data with normal distribution are expressed as mean±standard deviation(x s),and t-test is used;measurement data with skewed distribution is expressed by M(Q);the count data is expressed by rate,using Chi-square(?~2)test or Fisher accurate probability method,paralleling consistency Kappa test.P<0.05 was considered statistically significant.Result:1 The total detection rate of SLN in 37 patients with endometrial carcinoma was 94.59%(35/37).The unilateral detection rate was 18.92%(7/37,4 cases on the left side,3 cases on the right side),and the bilateral detection rate was 75.68%(28/37).The accuracy rate was 100%(35/35),the sensitivity was 100%(2/2),and the negative predictive value was 100%(33/33).2 A total of 223 SLNs were removed from 37 patients with endometrial carcinoma,accounting for 24.21%(223/921)of the total number of resected lymph nodes,with an average of 6.03 SLN per person.3 The distribution of SLN in 37 patients with endometrial carcinoma was mainly 41.26%(92/223)in the external area and 39.46%(88/223)in the closed area.4 The consistency of the metastasis of endometrial carcinoma SLN and pelvic and abdominal lymph nodes was analyzed,and the Kappa value was calculated to be 1.000,P<0.001.Therefore,SLN has a completely consistent metastatic state with the pelvic and abdominal lymph nodes.5 In 37 patients with endometrial carcinoma,there were 2 cases with SLN metastasis(4in total),all of which were pelvic lymph node metastasis.Among them,one metastatic SLN found outside the left iliac crest was a patient with stage II endometrial carcinoma,and the metastasis was confirmed to be micrometastases(MM)by CK pathological micrometastases.NSLN has not found any transfer.Conclusion:1 Nano-carbon tracing SLN has certain application value in endometrial carcinoma.2 The distribution of SLN in endometrial carcinoma is mainly located in the closed hole area and the extra-oral area.3 The detection rate and negative predictive value of SLN are the key criteria for evaluation.