Evaluating The Adoption of Carbon Nano-Particle in The Surgical Dissection and Pathologic Examination of Lymph Node for Lower Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YU Yongyang , WANG Cun , ZHENG Yangchun , SHU Ye , YANG Lie , ZHOU Zongguang

The Third Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Rectal cancer; 　　Lymph node; 　　Carbon nano-particle

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Objective To evaluate the adoption of carbon nano-particle in the pathologic examination of lymph node for lower rectal cancer. Methods Sixty consecutive patients with rectal cancers located at or below the peritoneal reflection were randomly allocated to the routine method group or the group using carbon nano-particle. Resultsof pathologic examination were compared. Results Altogether, 1 070 lymph nodes were examined from the 2 study groups. The average examined number of the carbon nano-particle group was (20.2±4.9)/case, which was significantly higher than the other group 〔(15.4±6.8)/case〕, P=0.003. More tiny lymph nodes were examined in the nano-particle group (P=0.029) and more metastases were proved from the lymph nodes dyed by nano-particle (P=0.000). The majority of examined lymph nodes were located along the superior rectal vessel and its branches. ConclusionAdoption of nano-particle in pathologic examination of rectal cancer surgery can increase the examined number of lymph nodes, while detect small nodes harboring cancer, thus ensuring the correctness of pathologic report. The distribution of mesorectal lymph nodes underlines the execution of TME principle in dissection.

Citation： YU Yongyang,WANG Cun,ZHENG Yangchun,SHU Ye,YANG Lie,ZHOU Zongguang. Evaluating The Adoption of Carbon Nano-Particle in The Surgical Dissection and Pathologic Examination of Lymph Node for Lower Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(5): 358-361. doi: Copy

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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, 周总光, 于永扬, 等. 低位直肠癌侧方转移和微转移的临床病理学研究 [Ｊ]. 中华外科杂志, 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, 卿三华, 黄祥成, 等. RT-PCR检测直肠癌在直肠系膜的播散范围及临床意义 [Ｊ]. 中国普外基础与临床杂志, 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. 郑阳春, 周总光. 结直肠癌前哨淋巴结活检的研究进展 [Ｊ]. 中国普外基础与临床杂志, 2004; 11(2)∶ 130.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluating The Adoption of Carbon Nano-Particle in The Surgical Dissection and Pathologic Examination of Lymph Node for Lower Rectal Cancer

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