• 四川大學(xué)華西醫(yī)院普外三科（成都610041）;

目的 研究納米炭淋巴示蹤劑在低位直腸癌手術(shù)淋巴結(jié)病理檢查中的價(jià)值。方法 60例腹膜返折及其下方的直腸癌，隨機(jī)分為常規(guī)與納米炭病檢組2組，比較2組淋巴結(jié)檢獲情況。 結(jié)果 2組共計(jì)檢獲淋巴結(jié)1 070枚，其中納米炭組平均為(20.2±4.9)枚/例，顯著高于常規(guī)病檢組〔(15.4±6.8)枚/例〕,P=0.003。納米炭組檢獲更多微小淋巴結(jié)（P=0.029)，炭著色淋巴結(jié)癌轉(zhuǎn)移檢出率更高（P=0.000）。2組檢獲淋巴結(jié)均以沿直腸上血管及其分支分布為主。結(jié)論 納米炭示蹤劑提高了淋巴結(jié)檢獲率，確保了病理檢查的準(zhǔn)確性； 直腸系膜內(nèi)淋巴結(jié)主要沿直腸上血管及其分支分布，證實(shí)了TME手術(shù)的廓清效果。

引用本文： 于永揚(yáng),王存,鄭陽(yáng)春,舒曄,楊烈,周總光. 比較研究納米炭示蹤劑在低位直腸癌淋巴結(jié)清掃及病理檢查中的價(jià)值. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008, 15(5): 358-361. doi: 復(fù)制

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1. Stocchi L, Nelson H, Sargent DJ, et al. Impact of surgical and pathologic variables in rectal cancer: a United States community and cooperative group report [Ｊ]. J Clin Oncol, 2001; 19(18)∶ 3895.
2. Nelson H, Petrelli N, Carlin A, et al. Guidelines 2000 for colon and rectal cancer surgery [Ｊ]. J Natl Cancer Inst, 2001; 93(8)∶ 583.
3. Heald RJ, Moran BJ, Ryall RD, et al. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997 [Ｊ]. Arch Surg, 1998; 133(8)∶ 894.
4. Hida J, Yasutomi M, Maruyama T, et al. Lymph node metastases detected in the mesorectum distal to carcinoma of the rectum by the clearing method: justification of total mesorectal excision [Ｊ]. J Am Coll Surg, 1997; 184(6)∶ 584.
5. Wibe A, Syse A, Andersen E, et al. Oncological outcomes after total mesorectal excision for cure for cancer of the lower rectum: anterior vs. abdominoperineal resection [Ｊ]. Dis Colon Rectum, 2004; 47(1)∶ 48.
6. Phang PT. Total mesorectal excision: technical aspects [Ｊ]. Can J Surg, 2004; 47(2)∶ 130.
7. Martling A, Singnomklao T, Holm T, et al. Prognostic significance of both surgical and pathological assessment of curative resection for rectal cancer [Ｊ]. Br J Surg, 2004; 91(8)∶ 1040.
8. Yokota T, Saito T, Narushima Y, et al. Lymph-node staining with activated carbon CH40: a new method for axillary lymph-node dissection in breast cancer [Ｊ]. Can J Surg, 2000; 43(3)∶ 191.
9. Okamoto K, Sawai K, Minato H, et al. Number and anatomical extent of lymph node metastases in gastric cancer: analysis using intra-lymph node injection of activated carbon particles (CH40) [Ｊ]. Jpn J Clin Oncol, 1999; 29(2)∶ 74.
10. 王存, 周總光, 于永揚(yáng), 等. 低位直腸癌側(cè)方轉(zhuǎn)移和微轉(zhuǎn)移的臨床病理學(xué)研究 [Ｊ]. 中華外科雜志, 2007; 45(17)∶ 1160.
11. Beart RW, Steele GD Jr, Menck HR, et al. Management and survival of patients with adenocarcinoma of the colon and rectum: a national survey of the Commission on Cancer [Ｊ]. J Am Coll Surg, 1995; 181(3)∶ 225.
12. Koyama Y, Kotake K. Overview of colorectal cancer in Japan: report from the Registry of the Japanese Society for Cancer of the Colon and Rectum [Ｊ]. Dis Colon Rectum, 1997; 40(10 Suppl)∶ S2.
13. McCall JL, Cox MR, Wattchow DA. Analysis of local recurrence rates after surgery alone for rectal cancer [Ｊ]. Int J Colorectal Dis, 1995; 10(3)∶ 126.
14. Bruch HP, Schwandner O, Schiedeck TH, et al. Actual standards and controversies on operative technique and lymph-node dissection in colorectal cancer [Ｊ]. Langenbecks Arch Surg, 1999; 384(2)∶ 167.
15. Steup WH, Moriya Y, van de Velde CJ. Patterns of lymphatic spread in rectal cancer. A topographical analysis on lymph node metastases [Ｊ]. Eur J Cancer, 2002; 38(7)∶ 911.
16. Baxter NN, Virnig DJ, Rothenberger DA, et al. Lymph node evaluation in colorectal cancer patients: a population-based study [Ｊ]. J Natl Cancer Inst, 2005; 97(3)∶ 219.
17. 王小林, 卿三華, 黃祥成, 等. RT-PCR檢測(cè)直腸癌在直腸系膜的播散范圍及臨床意義 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(1)∶ 29.
18. Wong JH, Bowles BJ, Bueno R, et al. Impact of the number of negative nodes on disease-free survival in colorectal cancer patients [Ｊ]. Dis Colon Rectum, 2002; 45(10)∶ 1341.
19. Compton CC, Fielding LP, Burgart LJ, et al. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999 [Ｊ]. Arch Pathol Lab Med, 2000; 124(7)∶ 979.
20. Wang C, Zhou Z, Wang Z, et al. Patterns of neoplastic foci and lymph node micrometastasis within the mesorectum [Ｊ]. Langenbecks Arch Surg, 2005; 390(4)∶ 312.
21. 鄭陽(yáng)春, 周總光. 結(jié)直腸癌前哨淋巴結(jié)活檢的研究進(jìn)展 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11(2)∶ 130.
  1. 1. Stocchi L, Nelson H, Sargent DJ, et al. Impact of surgical and pathologic variables in rectal cancer: a United States community and cooperative group report [Ｊ]. J Clin Oncol, 2001; 19(18)∶ 3895.
  2. 2. Nelson H, Petrelli N, Carlin A, et al. Guidelines 2000 for colon and rectal cancer surgery [Ｊ]. J Natl Cancer Inst, 2001; 93(8)∶ 583.
  3. 3. Heald RJ, Moran BJ, Ryall RD, et al. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997 [Ｊ]. Arch Surg, 1998; 133(8)∶ 894.
  4. 4. Hida J, Yasutomi M, Maruyama T, et al. Lymph node metastases detected in the mesorectum distal to carcinoma of the rectum by the clearing method: justification of total mesorectal excision [Ｊ]. J Am Coll Surg, 1997; 184(6)∶ 584.
  5. 5. Wibe A, Syse A, Andersen E, et al. Oncological outcomes after total mesorectal excision for cure for cancer of the lower rectum: anterior vs. abdominoperineal resection [Ｊ]. Dis Colon Rectum, 2004; 47(1)∶ 48.
  6. 6. Phang PT. Total mesorectal excision: technical aspects [Ｊ]. Can J Surg, 2004; 47(2)∶ 130.
  7. 7. Martling A, Singnomklao T, Holm T, et al. Prognostic significance of both surgical and pathological assessment of curative resection for rectal cancer [Ｊ]. Br J Surg, 2004; 91(8)∶ 1040.
  8. 8. Yokota T, Saito T, Narushima Y, et al. Lymph-node staining with activated carbon CH40: a new method for axillary lymph-node dissection in breast cancer [Ｊ]. Can J Surg, 2000; 43(3)∶ 191.
  9. 9. Okamoto K, Sawai K, Minato H, et al. Number and anatomical extent of lymph node metastases in gastric cancer: analysis using intra-lymph node injection of activated carbon particles (CH40) [Ｊ]. Jpn J Clin Oncol, 1999; 29(2)∶ 74.
  10. 10. 王存, 周總光, 于永揚(yáng), 等. 低位直腸癌側(cè)方轉(zhuǎn)移和微轉(zhuǎn)移的臨床病理學(xué)研究 [Ｊ]. 中華外科雜志, 2007; 45(17)∶ 1160.
  11. 11. Beart RW, Steele GD Jr, Menck HR, et al. Management and survival of patients with adenocarcinoma of the colon and rectum: a national survey of the Commission on Cancer [Ｊ]. J Am Coll Surg, 1995; 181(3)∶ 225.
  12. 12. Koyama Y, Kotake K. Overview of colorectal cancer in Japan: report from the Registry of the Japanese Society for Cancer of the Colon and Rectum [Ｊ]. Dis Colon Rectum, 1997; 40(10 Suppl)∶ S2.
  13. 13. McCall JL, Cox MR, Wattchow DA. Analysis of local recurrence rates after surgery alone for rectal cancer [Ｊ]. Int J Colorectal Dis, 1995; 10(3)∶ 126.
  14. 14. Bruch HP, Schwandner O, Schiedeck TH, et al. Actual standards and controversies on operative technique and lymph-node dissection in colorectal cancer [Ｊ]. Langenbecks Arch Surg, 1999; 384(2)∶ 167.
  15. 15. Steup WH, Moriya Y, van de Velde CJ. Patterns of lymphatic spread in rectal cancer. A topographical analysis on lymph node metastases [Ｊ]. Eur J Cancer, 2002; 38(7)∶ 911.
  16. 16. Baxter NN, Virnig DJ, Rothenberger DA, et al. Lymph node evaluation in colorectal cancer patients: a population-based study [Ｊ]. J Natl Cancer Inst, 2005; 97(3)∶ 219.
  17. 17. 王小林, 卿三華, 黃祥成, 等. RT-PCR檢測(cè)直腸癌在直腸系膜的播散范圍及臨床意義 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(1)∶ 29.
  18. 18. Wong JH, Bowles BJ, Bueno R, et al. Impact of the number of negative nodes on disease-free survival in colorectal cancer patients [Ｊ]. Dis Colon Rectum, 2002; 45(10)∶ 1341.
  19. 19. Compton CC, Fielding LP, Burgart LJ, et al. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999 [Ｊ]. Arch Pathol Lab Med, 2000; 124(7)∶ 979.
  20. 20. Wang C, Zhou Z, Wang Z, et al. Patterns of neoplastic foci and lymph node micrometastasis within the mesorectum [Ｊ]. Langenbecks Arch Surg, 2005; 390(4)∶ 312.
  21. 21. 鄭陽(yáng)春, 周總光. 結(jié)直腸癌前哨淋巴結(jié)活檢的研究進(jìn)展 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11(2)∶ 130.