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Surgical Endoscopy
Published in: Surgical Endoscopy 4/2016

01-04-2016

A multicenter study of using carbon nanoparticles to show sentinel lymph nodes in early gastric cancer

Authors: Jun Yan, Xiaoling Zheng, Zhangyuanzhu Liu, Jiang Yu, Zhenwei Deng, Fangqing Xue, Yu Zheng, Feng Chen, Hong Shi, Gang Chen, Jianping Lu, Lisheng Cai, Mingzhi Cai, Gao Xiang, Yunfeng Hong, Wenbo Chen, Guoxin Li

Published in: Surgical Endoscopy | Issue 4/2016

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Abstract

Background

Lymph node metastasis occurs in approximately 10 % of early gastric cancer. Preoperative or intra-operative identification of lymph node metastasis in early gastric cancer is crucial for surgical planning. The purpose of this study was to evaluate the feasibility of using carbon nanoparticles to show sentinel lymph nodes (SLNs) in early gastric cancer.

Methods

A multicenter study was performed between July 2012 and November 2014. Ninety-one patients with early gastric cancer identified by preoperative endoscopic ultrasonography were recruited. One milliliter carbon nanoparticles suspension, which is approved by Chinese Food and Drug Administration, was endoscopically injected into the submucosal layer at four points around the site of the primary tumor 6–12 h before surgery. Laparoscopic radical resection with D2 lymphadenectomy was performed. SLNs were defined as nodes that were black-dyed by carbon nanoparticles in greater omentum and lesser omentum near gastric cancer. Lymph node status and SLNs accuracy were confirmed by pathological analysis.

Results

All patients had black-dyed SLNs lying in greater omentum and/or lesser omentum. SLNs were easily found under laparoscopy. The mean number of SLNs was 4 (range 1–9). Carbon nanoparticles were around cancer in specimen. After pathological analysis, 10 patients (10.99 %) had lymph node metastasis in 91 patients with early gastric cancer. SLNs were positive in 9 cases and negative in 82 cases. In pathology, carbon nanoparticles were seen in lymphatic vessels, lymphoid sinus, and macrophages in SLNs. When SLNs were positive, cancer cells were seen in lymph nodes. The sensitivity, specificity, and accuracy of black-dyed SLNs in early gastric cancers were 90, 100, and 98.9 %, respectively. No patient had any side effects of carbon nanoparticles in this study.

Conclusions

It is feasible to use carbon nanoparticles to show SLNs in early gastric cancer. Carbon nanoparticles suspension is safe for submucosal injection.
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Metadata
Title
A multicenter study of using carbon nanoparticles to show sentinel lymph nodes in early gastric cancer
Authors
Jun Yan
Xiaoling Zheng
Zhangyuanzhu Liu
Jiang Yu
Zhenwei Deng
Fangqing Xue
Yu Zheng
Feng Chen
Hong Shi
Gang Chen
Jianping Lu
Lisheng Cai
Mingzhi Cai
Gao Xiang
Yunfeng Hong
Wenbo Chen
Guoxin Li
Publication date
01-04-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4358-8

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