Application of carbon nanoparticles in laparoscopic sentinel lymph node detection in patients with early-stage cervical cancer

Yan Lu, Jin-Ying Wei, De-Sheng Yao, Zhong-Mian Pan, Yao Yao, Yan Lu, Jin-Ying Wei, De-Sheng Yao, Zhong-Mian Pan, Yao Yao

Abstract

Objective: To investigate the value of carbon nanoparticles in identifying sentinel lymph nodes in early-stage cervical cancer.

Methods: From January 2014 to January 2016, 40 patients with cervical cancer stage IA2-IIA, based on the International Federation of Gynecology and Obstetrics (FIGO) 2009 criteria, were included in this study. The normal cervix around the tumor was injected with a total of 1 mL of carbon nanoparticles (CNP)at 3 and 9 o'clock. All patients then underwent laparoscopic pelvic lymph node dissection and radical hysterectomy. The black-dyed sentinel lymph nodes were removed for routine pathological examination and immunohistochemical staining.

Results: Among the 40 patients, 38 patients had at least one sentinel lymph node (SLN). The detection rate was 95% (38/40). One hundred seventy-three SLNs were detected with an average of 3.9 SLNs per side. 25 positive lymph nodes, which included 21 positive SLNs, were detected in 8 (20%) patients. Sentinel lymph nodes were localized in the obturator (47.97%), internal lilac (13.87%), external lilac (26.59%), parametrial (1.16%), and common iliac (8.67%) regions. The sensitivity of the SLN detection was 100% (5/5), the accuracy was 97.37% (37/38), and the negative predictive value was 100. 0% and the false negative rate was 0%.

Conclusions: Sentinel lymph nodes can be used to accurately predict the pathological state of pelvic lymph nodes in early cervical cancer. The detection rates and accuracy of sentinel lymph node were high. Carbon nanoparticles can be used to trace the sentinel lymph node in early cervical cancer.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Right external iliac sentinel lymph…
Fig 1. Right external iliac sentinel lymph node.
(A) Intraoperative right external iliac lymph node mapping. (B) Postoperative right external iliac lymph node profile.
Fig 2. Black-stained lymphatic vessels.
Fig 2. Black-stained lymphatic vessels.
(A)Retroperitoneal black stained lymphatic vessels. (B)CNP black stained lymphatic vessels.
Fig 3. Black-stained sentinel lymph node.
Fig 3. Black-stained sentinel lymph node.
(A)SLN of hematoxylin-eosin(HE)stained pathology(100x). (B)SLN of hematoxylin-eosin(HE)stained pathology(400x).

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