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纳米碳示踪剂在结直肠癌微创根治手术后淋巴结检出的应用进展
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Abstract:
结直肠癌是中国最常见的消化系统恶性肿瘤之一,且在全球结直肠癌新发病例数中,其发病率及死亡率在男女性别中均位列第三,结直肠癌极大地损害了人民身体健康。结直肠癌的进展机制是肿瘤细胞无限制增殖、侵犯周围组织和器官,同时伴随转移的过程。结直肠癌淋巴结转移引起局部复发和远处转移是决定预后情况的一个重要独立指标。因此能够准确确定肿瘤位置、示踪区域淋巴结,对于降低手术难度,提高术后淋巴结检出数目及临床病理分期的准确性有着重要作用。纳米碳是一种新型淋巴示踪剂,具有淋巴系统趋向性、安全性、长效性等优势,因此在结直肠癌手术中得到了广泛应用。应用纳米碳示踪淋巴结对结直肠癌患者微创根治术后淋巴结的检出率及其检测方法的优势是值得深入探讨的课题,本文就此展开叙述并进一步讨论未来的研究方向。
Colorectal cancer is one of the most common malignant tumors of digestive system in China. And in the number of new cases of colorectal cancer in the world, its morbidity and mortality rank third among both sexes. Colorectal cancer is a great detriment to people’s health. The progression mechanism of colorectal cancer is the unrestricted proliferation of tumor cells, invasion of surrounding tissues and organs, accompanied by the process of metastasis. Local recurrence and distant metastasis caused by lymph node metastasis of colorectal cancer is an important independent indicator to determine prognosis. Therefore, accurate determination of tumor location and tracing of regional lymph nodes plays an important role in reducing the difficulty of surgery, increasing the number of postoperative lymph nodes detected, and improving the accuracy of clinicopathological staging. Nano-carbon is a new type of lymphatic tracer, which has the advantages of lymphatic system, safety, long-term performance, etc. So it has been widely used in colorectal cancer surgery. The detection rate of lymph nodes after minimally invasive radical surgery in patients with colorectal cancer and the advantages of the detection method are worthy of further discussion. This paper describes and further discusses the future research direction.
[1] | Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R.L., Soerjomataram, I., et al. (2024) Global Cancer Statistics 2022: Globocan Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 74, 229-263. https://doi.org/10.3322/caac.21834 |
[2] | 中华医学会外科学分会腹腔镜与内镜外科学组, 中华医学会外科学分会结直肠外科学组, 中国医师协会外科医师分会结直肠外科医师委员会, 等. 腹腔镜结直肠癌根治术操作指南(2018版) [J]. 中华消化外科杂志, 2018, 17(9): 877-885. |
[3] | Yeung, J.M.C., Maxwell‐Armstrong, C. and Acheson, A.G. (2009) Colonic Tattooing in Laparoscopic Surgery Making the Mark? Colorectal Disease, 11, 527-530. https://doi.org/10.1111/j.1463-1318.2008.01706.x |
[4] | Yang, M., Pepe, D., Schlachta, C.M. and Alkhamesi, N.A. (2017) Endoscopic Tattoo: The Importance and Need for Standardized Guidelines and Protocol. Journal of the Royal Society of Medicine, 110, 287-291. https://doi.org/10.1177/0141076817712244 |
[5] | 唐诣超, 冯勇. 淋巴结检出数对直肠癌治疗影响的研究进展[J]. 临床与病理杂志, 2018, 38(8): 1768-1774. |
[6] | 杨凯, 侯远发, 宋耀明, 等. 直肠癌新辅助治疗后手术标本的淋巴结检出[J]. 中国实用医药, 2014, 9(11): 79-80. |
[7] | 武雪亮, 王立坤, 薛军, 等. 直肠癌全系膜切除术后局部复发影响因素分析[J]. 中国全科医学, 2014, 17(30): 3550-3553. |
[8] | 何振华, 张森, 宋现青, 等. 结直肠癌腹膜种植转移的相关因素分析[J]. 中国肿瘤临床, 2013, 40(2): 107-110. |
[9] | 张珂珲, 胡仁豪, 张顺, 等. 腹腔镜胃肠道肿瘤手术定位方法[J]. 中国普外基础与临床杂志, 2024, 31(2): 229-235. |
[10] | 姚瑶, 沈海玉, 单军奇, 等. 纳米碳标记结直肠癌微转移淋巴结应用价值[J]. 中华肿瘤防治杂志, 2023, 30(19): 1196-1200. |
[11] | Park, J.W., Sohn, D.K., Hong, C.W., Han, K.S., Choi, D.H., Chang, H.J., et al. (2007) The Usefulness of Preoperative Colonoscopic Tattooing Using a Saline Test Injection Method with Prepackaged Sterile India Ink for Localization in Laparoscopic Colorectal Surgery. Surgical Endoscopy, 22, 501-505. https://doi.org/10.1007/s00464-007-9495-2 |
[12] | 申虹, 魏伯俊, 冯睡, 等. 纳米碳在甲状腺癌颈部VI区淋巴清扫中的应用价值[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(10): 817-820. |
[13] | 洪强, 汪勇, 王建军, 等. 术前胃镜下注射法纳米碳淋巴结示踪技术在腹腔镜胃癌根治术中的应用[J]. 中华医学杂志, 2017, 97(2): 123-126. |
[14] | 付建, 王敏, 乔春红, 等. 纳米碳标记前哨淋巴结对内生型宫颈癌腹腔淋巴结转移情况的示踪价值研究[J]. 中国肿瘤外科杂志, 2024, 16(1): 67-70. |
[15] | 孙杰. 纳米碳在腹腔镜胃及结直肠癌手术中的应用[D]: [博士学位论文]. 济南: 山东大学, 2018. |
[16] | 张润, 王思洋, 汪晓东, 等. 纳米碳的临床应用研究进展[J]. 肿瘤学杂志, 2012, 18(11): 865-869. |
[17] | 王蓉, 詹红丽, 李达周, 等. 内镜下注射标记纳米碳在进展期结直肠癌治疗中的应用研究[J]. 中华胃肠外科杂志, 2020, 23(1): 56-64. |
[18] | 刘江文, 仝德峰, 牛建华, 等. 纳米炭混悬液对进展期胃癌前哨淋巴结示踪定位及指导淋巴结清扫范围的临床研究[J]. 中国肿瘤临床, 2011, 38(10): 576-578. |
[19] | 余仁涛. 纳米炭联合CK20在腹腔镜直肠癌根治术中对淋巴结的检出和术后检测淋巴结转移的影响[D]: [硕士学位论文]. 荆州: 长江大学, 2022. |
[20] | 郝婷婷, 申妮, 张锦, 等. 结直肠癌患者微创根治手术后淋巴结检出影响因素及纳米碳示踪应用价值分析[J]. 肿瘤学杂志, 2022, 28(2): 117-121. |
[21] | 杨祖立, 汪建平, 黄美近, 等. 结直肠癌淋巴结转移规律及其相关因素的分析[J]. 大肠肛门病外科杂志, 2004, 10(1): 16-18. |
[22] | Yan, J., Xue, F., Chen, H., Wu, X., Zhang, H., Chen, G., et al. (2014) A Multi-Center Study of Using Carbon Nanoparticles to Track Lymph Node Metastasis in T1-2 Colorectal Cancer. Surgical Endoscopy, 28, 3315-3321. https://doi.org/10.1007/s00464-014-3608-5 |
[23] | 黄凯, 焦守峰, 彭德新, 等. 术前CT淋巴结定位联合纳米碳示踪技术在胃癌根治术中的应用[J]. 中国现代医学杂志, 2019, 29(9): 62-65. |
[24] | 罗明月, 周康荣. CT结肠造影术四种后处理方法检查结直肠癌的比较研究[J]. 中华放射学杂志, 2001, 35(10): 65-68. |
[25] | 夏旭, 刘伟, 欧勇, 等. 纳米碳引导下腹腔镜中低位直肠癌根治术24例临床观察[J]. 中国临床研究, 2015, 28(6): 776-778. |