• 四川大學華西醫(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淋巴結病理檢查中的價值。方法 60例腹膜返折及其下方的直腸癌，隨機分為常規(guī)與納米炭病檢組2組，比較2組淋巴結檢獲情況。 結果 2組共計檢獲淋巴結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（P=0.029)，炭著色淋巴結癌轉移檢出率更高（P=0.000）。2組檢獲淋巴結均以沿直腸上血管及其分支分布為主。結論 納米炭示蹤劑提高了淋巴結檢獲率，確保了病理檢查的準確性； 直腸系膜內(nèi)淋巴結主要沿直腸上血管及其分支分布，證實了TME手術的廓清效果。

引用本文： 于永揚,王存,鄭陽春,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清掃及病理檢查中的價值. 中國普外基礎與臨床雜志, 2008, 15(5): 358-361. doi: 復制

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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.
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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檢測直腸癌在直腸系膜的播散范圍及臨床意義 [Ｊ]. 中國普外基礎與臨床雜志, 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. 鄭陽春, 周總光. 結直腸癌前哨淋巴結活檢的研究進展 [Ｊ]. 中國普外基礎與臨床雜志, 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, 等. 低位直腸癌側方轉移和微轉移的臨床病理學研究 [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檢測直腸癌在直腸系膜的播散范圍及臨床意義 [Ｊ]. 中國普外基礎與臨床雜志, 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. 鄭陽春, 周總光. 結直腸癌前哨淋巴結活檢的研究進展 [Ｊ]. 中國普外基礎與臨床雜志, 2004; 11(2)∶ 130.