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Shao F, Zhou Q, Yu F, Pan L, Li L. Clinical value of nano-carbon lymphatic tracer for regional lymph node dissections of rectal cancer after neoadjuvant chemoradiotherapy. J Appl Clin Med Phys 2024:e14406. [PMID: 38820538 DOI: 10.1002/acm2.14406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVES Regional lymph node (LN) volume decreases after neoadjuvant therapy, requiring a tracer for more accurate detection. Nano-carbon tracer is a third-generation tracer with several advantages, but its use for LN detection after neoadjuvant chemoradiotherapy for middle and low rectal cancer remains unclear. Therefore, this study investigated the effects and safety of anoscope-guided subrectal injections of nano-carbon suspension in this patient population. METHODS This study retrospectively reviewed the medical records of 45 patients with middle and low rectal cancer admitted to our institution from March 2019 to March 2022. All patients received preoperative neoadjuvant chemotherapy and radiotherapy and were divided into nano-carbon injection (n = 23; anoscope-guided injections of nano-carbon suspension in the rectal submucosa 2 cm above the dentate line 24 h preoperatively) and control (n = 22; directly underwent surgery) groups. The LN detection and complication rates were compared between the groups. RESULTS The total and mean numbers of LNs and small LNs and the number of patients with > 12 LNs were significantly higher in the nano-carbon injection group than in the control group. The total number of positive LNs and LN metastasis did not differ between the groups, nor did the anastomotic leakage, bleeding, stenosis, and abscess occurrence rates. CONCLUSIONS Anoscope-guided nano-carbon lymphatic tracing increased the LN detection rate, caused less trauma, and resulted in fewer postoperative complications than the direct surgical procedure. Thus, it is an effective, safe, and practical method that may improve dissections and the postoperative pathological staging accuracy.
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Affiliation(s)
- Feng Shao
- Department of Anorectal surgery, Dongyang People Hospital (affiliated Dongyang Hospital of Wenzhou Medical University), Dongyang, Zhejiang province, China
| | - Qi Zhou
- Department of Anorectal surgery, Dongyang People Hospital (affiliated Dongyang Hospital of Wenzhou Medical University), Dongyang, Zhejiang province, China
| | - Fei Yu
- Department of Anorectal surgery, Dongyang People Hospital (affiliated Dongyang Hospital of Wenzhou Medical University), Dongyang, Zhejiang province, China
| | - Lelin Pan
- The First Affilated Hospital, Zhejiang University School of Medicine Qingchunlu, Zhejiang, China
| | - Lijun Li
- Department of Anorectal surgery, Dongyang People Hospital (affiliated Dongyang Hospital of Wenzhou Medical University), Dongyang, Zhejiang province, China
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Semenov KN, Ageev SV, Kukaliia ON, Murin IV, Petrov AV, Iurev GO, Andoskin PA, Panova GG, Molchanov OE, Maistrenko DN, Sharoyko VV. Application of carbon nanostructures in biomedicine: realities, difficulties, prospects. Nanotoxicology 2024; 18:181-213. [PMID: 38487921 DOI: 10.1080/17435390.2024.2327053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/02/2024] [Indexed: 05/02/2024]
Abstract
The review systematizes data on the wide possibilities of practical application of carbon nanostructures. Much attention is paid to the use of carbon nanomaterials in medicine for the visualization of tumors during surgical interventions, in the creation of cosmetics, as well as in agriculture in the creation of fertilizers. Additionally, we demonstrate trends in research in the field of carbon nanomaterials with a view to elaborating targeted drug delivery systems. We also show the creation of nanosized medicinal substances and diagnostic systems, and the production of new biomaterials. A separate section is devoted to the difficulties in studying carbon nanomaterials. The review is intended for a wide range of readers, as well as for experts in the field of nanotechnology and nanomedicine.
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Affiliation(s)
- Konstantin N Semenov
- Department of General and Bioorganic Chemistry, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
- Institute of Chemistry, Saint Petersburg State University, Saint Petersburg, Russia
- Department of Basic Research, A. M. Granov Russian Research Centre for Radiology and Surgical Technologies, Saint Petersburg, Russia
| | - Sergei V Ageev
- Department of General and Bioorganic Chemistry, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
- Institute of Chemistry, Saint Petersburg State University, Saint Petersburg, Russia
| | - Olegi N Kukaliia
- Department of General and Bioorganic Chemistry, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Igor V Murin
- Institute of Chemistry, Saint Petersburg State University, Saint Petersburg, Russia
| | - Andrey V Petrov
- Institute of Chemistry, Saint Petersburg State University, Saint Petersburg, Russia
| | - Gleb O Iurev
- Department of General and Bioorganic Chemistry, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Pavel A Andoskin
- Department of General and Bioorganic Chemistry, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Gaiane G Panova
- Light Physiology of Plants, Agrophysical Research Institute, Saint Petersburg, Russia
| | - Oleg E Molchanov
- Department of General and Bioorganic Chemistry, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
- Department of Basic Research, A. M. Granov Russian Research Centre for Radiology and Surgical Technologies, Saint Petersburg, Russia
| | - Dmitrii N Maistrenko
- Department of Basic Research, A. M. Granov Russian Research Centre for Radiology and Surgical Technologies, Saint Petersburg, Russia
| | - Vladimir V Sharoyko
- Department of General and Bioorganic Chemistry, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
- Institute of Chemistry, Saint Petersburg State University, Saint Petersburg, Russia
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Zhao J, Wang J, Cheng R, Qin J, Ai Z, Sun H, Guo Z, Zhang X, Zheng X, Gao M. Safety and effectiveness of carbon nanoparticles suspension-guided lymph node dissection during thyroidectomy in patients with thyroid papillary cancer: a prospective, multicenter, randomized, blank-controlled trial. Front Endocrinol (Lausanne) 2024; 14:1251820. [PMID: 38260138 PMCID: PMC10801185 DOI: 10.3389/fendo.2023.1251820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Objective This study aimed to evaluate the effectiveness and safety of carbon nanoparticles-guided lymph node dissection during thyroidectomy in patients with papillary thyroid cancer(PTC). Methods Clinical trials consisted of two subgroups: unilateral lobectomy (UL; n=283) and total thyroidectomy (TT; n=286). From each subgroup, the patients were randomly assigned to two groups: the carbon nanoparticle group and control group. Primary endpoints included parathyroid hormone (PTH) levels, number of lymph nodes (LNs) detected, number of tiny lymph nodes detected, and recognition and retention of the parathyroid glands. Secondary endpoint was recognition and protection of the recurrent laryngeal nerve. Results A total of 569 patients with PTC were recruited. There were no statistically significant differences in demographics between the carbon nanoparticles and control groups (P > 0.05). In the UL subgroup, there were no significant differences in PTH levels between the two groups at preoperative, intraoperative, and postoperative day one, and postoperative month one (P>0.05). There was no significant difference in the serum Ca2+ levels between the two groups preoperatively and at postoperative month one (P>0.05). The number of lymph nodes dissected in the carbon nanoparticles group was significantly higher than that in the control group (P<0.0001). The detection rate of tiny lymph nodes in the carbon nanoparticles group was higher than that in the control group (P=0.0268). In the TT subgroup, there was no significant difference in PTH levels between the two groups at preoperative, intraoperative, and postoperative day one (P>0.05). However, the mean PTH level in the carbon nanoparticles group was significantly higher than that of the control group at postoperative month one (P=0.0368). There was no significant difference in the serum Ca2+ levels between the two groups preoperatively and at postoperative month one (P>0.05). There were no significant differences between the two groups in the number of dissected LNs (P>0.05) or the detection rate of tiny lymph nodes (P>0.05). No drug-related AE and complications due to the injection of carbon nanoparticles were recorded in this study. There were no significant differences between the two groups in terms of parathyroid preserved in situ and recurrent laryngeal nerve injury in the UL and TT subgroups. Conclusions Carbon nanoparticles demonstrated efficacy and safety in thyroidectomy. The application of carbon nanoparticles could significantly facilitate the identification and clearance of LNs and the optimum preservation of parathyroid function. Clinical trial registration https://www.chictr.org.cn/, identifier ChiCTR2300068502.
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Affiliation(s)
- Jingzhu Zhao
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Junyi Wang
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Ruochuan Cheng
- Department of Thyroid Disease Diagnosis and Treatment Center, First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Jianwu Qin
- Department of Thyroid & Neck Surgery, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhilong Ai
- General Surgery, Zhongshan Hospital Fudan University, Shanghai, China
| | - Hui Sun
- Department of Thyroid Surgery, China Japan Union Hospital of Jilin University, Jilin, China
| | - Zhuming Guo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiaohua Zhang
- Department of Thyroid & Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiangqian Zheng
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Ming Gao
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Department of Breast and Thyroid Diseases, Tianjin Union Medical Center, Tianjin, China
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Koimtzis G, Geropoulos G, Stefanopoulos L, Chalklin CG, Karniadakis I, Alexandrou V, Tteralli N, Carrington-Windo E, Papacharalampous A, Psarras K. The Role of Carbon Nanoparticles as Lymph Node Tracers in Colorectal Cancer: A Systematic Review and Meta-Analysis. Int J Mol Sci 2023; 24:15293. [PMID: 37894972 PMCID: PMC10607187 DOI: 10.3390/ijms242015293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Colorectal malignancies are the third-most common malignancies worldwide, with a rising incidence. Surgery remains the treatment of choice and adequate lymph node dissection is required for accurate staging. The objective of this study is to assess the use of carbon nanoparticles in lymph node tracing and resection in cases of colorectal cancer. For that purpose, we conducted a systematic review and meta-analysis of studies included in Medline, Scopus, Embase, Cochrane Library, and Google Scholar databases. In the end, ten studies with a total number of 1418 patients were included in the final statistical analysis. The meta-analysis carried out showed that the use of carbon nanoparticles results in an increased number of lymph nodes harvested (WMD 6.15, 95% CI 4.14 to 8.16, p < 0.001) and a higher rate of cases with more than 12 lymph nodes harvested (OR 9.57, 95% CI 2.87 to 31.96, p = 0.0002). As a consequence, we suggest that carbon nanoparticles are used on a wider scale and that future research focuses on assessing the association between their use and overall patient survival. This study is limited by the fact that all included studies originate from China and by the fact that certain oncologic parameters and long-term outcomes have not been taken into account in the analysis.
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Affiliation(s)
- Georgios Koimtzis
- Department of General Surgery, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK;
| | - Georgios Geropoulos
- Western General Hospital, NHS Lothian, Crewe Road South, Edinburgh EH4 2XU, UK;
| | - Leandros Stefanopoulos
- Department of Electrical and Computer Engineering, Northwestern University, 633 Clark St, Evanston, IL 60208, USA;
| | - Christopher Gwydion Chalklin
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (I.K.)
| | - Ioannis Karniadakis
- Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; (C.G.C.); (I.K.)
| | - Vyron Alexandrou
- Urology Department, General Hospital of Thessaloniki “G. Gennimata-Agios Dimitrios”, Elenis Zografou 2, 54634 Thessaloniki, Greece;
| | - Nikos Tteralli
- Department of General Surgery, North Hampshire NHS Foundation Trust, Basingstoke RG24 9NA, UK;
| | - Eliot Carrington-Windo
- Department of General Surgery, Grange University Hospital, Caerleon Road, Llanfrechfa, Cwmbran NP44 8YN, UK;
| | | | - Kyriakos Psarras
- Second Surgical Propedeutic Department, School of Medicine, Ippokrateio General Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece
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Lin N, Wang Y, Yu C, Wu W, Fang Y, Yang J, Liu W, Wang R, Jiang Y, Wang Y. Endoscopic ultrasound-guided injection of carbon nanoparticles suspension to label rectal cancer before neoadjuvant chemoradiotherapy: a retrospective cohort study. Gastroenterol Rep (Oxf) 2023; 11:goad062. [PMID: 37842199 PMCID: PMC10570992 DOI: 10.1093/gastro/goad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/17/2023] Open
Abstract
Background Localization of the primary tumor and ensuring safe distal surgical margins (DSMs) following neoadjuvant chemoradiotherapy (nCRT) are challenging in locally advanced rectal cancers (LARCs). This study investigated the effectiveness of carbon nanoparticles suspension (CNS) for labeling the primary tumor and allowing precise tumor resection after nCRT. Methods Clinicopathological data of LARC patients who underwent nCRT followed by laparoscopic radical anal preservation surgery at our center between January 2018 and February 2023 were prospectively collected. The patients were divided into the CNS tattooed (CNS) and non-tattooed (control) groups. In the CNS group, CNS was injected in four quadrants on the anal side 1 cm away from the lower tumor margin. DSMs were determined through intraoperative distal rectal examination in the control group and observation of CNS tattoos in the CNS group. DSM lengths and positive DSM rates were compared between the two groups to analyse the feasibility and effectiveness of CNS for labeling LARCs before nCRT. Results There was no statistically significant difference in the basic demographic data, effectiveness of nCRT, or post-operative recovery rates between the two groups (all P > 0.05). In the CNS group, CNS tattoos were observed on the outside of the rectal wall, with an overall efficiency of 87.1% (27/31). The CNS group had fewer positive DSMs and safer DSM lengths (2.73 ± 0.88 vs 2.12 ± 1.15 cm, P = 0.012) than the control group (P < 0.05). Conclusions Endoscopic ultrasound-guided injection of CNS tattoos before nCRT could effectively label the LARCs, ensuring safe DSMs during anus-preserving surgeries (Chictr.org.cn No.: ChiCTR2300068991).
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Affiliation(s)
- Nan Lin
- Fuzong Clinical Medical College of Fujian Medical University, Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
| | - Yuanzhao Wang
- Department of General Surgery, Dongfang Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P. R. China
| | - Changwei Yu
- Department of Breast Surgery, Affiliated Fuzhou First Hospital of Fujian Medical University, Fuzhou, P. R. China
| | - Weihang Wu
- Fuzong Clinical Medical College of Fujian Medical University, Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
| | - Yongchao Fang
- Fuzong Clinical Medical College of Fujian Medical University, Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
| | - Jin Yang
- Fuzong Clinical Medical College of Fujian Medical University, Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
| | - Wangwu Liu
- Fuzong Clinical Medical College of Fujian Medical University, Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
| | - Rong Wang
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
| | - Yanyan Jiang
- Department of Ultrasonography, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
| | - Yu Wang
- Fuzong Clinical Medical College of Fujian Medical University, Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, P. R. China
- Department of General Surgery, Dongfang Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P. R. China
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He P, Tang H, Zheng Y, Xiong Y, Cheng H, Li J, Zhang Y, Liu G. Advances in nanomedicines for lymphatic imaging and therapy. J Nanobiotechnology 2023; 21:292. [PMID: 37620846 PMCID: PMC10463797 DOI: 10.1186/s12951-023-02022-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Lymph nodes play a pivotal role in tumor progression as key components of the lymphatic system. However, the unique physiological structure of lymph nodes has traditionally constrained the drug delivery efficiency. Excitingly, nanomedicines have shown tremendous advantages in lymph node-specific delivery, enabling distinct recognition and diagnosis of lymph nodes, and hence laying the foundation for efficient tumor therapies. In this review, we comprehensively discuss the key factors affecting the specific enrichment of nanomedicines in lymph nodes, and systematically summarize nanomedicines for precise lymph node drug delivery and therapeutic application, including the lymphatic diagnosis and treatment nanodrugs and lymph node specific imaging and identification system. Notably, we delve into the critical challenges and considerations currently facing lymphatic nanomedicines, and futher propose effective strategies to address these issues. This review encapsulates recent findings, clinical applications, and future prospects for designing effective nanocarriers for lymphatic system targeting, with potential implications for improving cancer treatment strategies.
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Affiliation(s)
- Pan He
- Department of Hepatobiliary Surgery, Academician (Expert) Workstation, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637600, China
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, 361002, China
| | - Haitian Tang
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, 361002, China
| | - Yating Zheng
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, 361002, China
| | - Yongfu Xiong
- Department of Hepatobiliary Surgery, Academician (Expert) Workstation, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637600, China
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, 361002, China
| | - Hongwei Cheng
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, 361002, China
| | - Jingdong Li
- Department of Hepatobiliary Surgery, Academician (Expert) Workstation, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637600, China.
| | - Yang Zhang
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, 361002, China.
| | - Gang Liu
- State Key Laboratory of Vaccines for Infectious Diseases, Center for Molecular Imaging and Translational Medicine, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, 361002, China.
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Lucas K, Melling N, Giannou AD, Reeh M, Mann O, Hackert T, Izbicki JR, Perez D, Grass JK. Lymphatic Mapping in Colon Cancer Depending on Injection Time and Tracing Agent: A Systematic Review and Meta-Analysis of Prospective Designed Studies. Cancers (Basel) 2023; 15:3196. [PMID: 37370806 PMCID: PMC10296374 DOI: 10.3390/cancers15123196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
An optimized lymph node yield leads to better survival in colon cancer, but extended lymphadenectomy is not associated with survival benefits. Lymphatic mapping shows several colon cancers feature aberrant drainage pathways inducing local recurrence when not resected. Currently, different protocols exist for lymphatic mapping procedures. This meta-analysis assessed which protocol has the best capacity to detect tumor-draining and possibly metastatic lymph nodes. A systematic review was conducted according to PRISMA guidelines, including prospective trials with in vivo tracer application. The risk of bias was evaluated using the QUADAS-2 tool. Traced lymph nodes, total resected lymph nodes, and aberrant drainage detection rate were analyzed. Fifty-eight studies met the inclusion criteria, of which 42 searched for aberrant drainage. While a preoperative tracer injection significantly increased the traced lymph node rates compared to intraoperative tracing (30.1% (15.4, 47.3) vs. 14.1% (11.9, 16.5), p = 0.03), no effect was shown for the tracer used (p = 0.740) or the application sites comparing submucosal and subserosal injection (22.9% (14.1, 33.1) vs. 14.3% (12.1, 16.8), p = 0.07). Preoperative tracer injection resulted in a significantly higher rate of detected aberrant lymph nodes compared to intraoperative injection (26.3% [95% CI 11.5, 44.0] vs. 2.5% [95% CI 0.8, 4.7], p < 0.001). Analyzing 112 individual patient datasets from eight studies revealed a significant impact on aberrant drainage detection for injection timing, favoring preoperative over intraoperative injection (OR 0.050 [95% CI 0.010-0.176], p < 0.001) while indocyanine green presented itself as the superior tracer (OR 0.127 [95% CI 0.018-0.528], p = 0.012). Optimized lymphatic mapping techniques result in significantly higher detection of aberrant lymphatic drainage patterns and thus enable a personalized approach to reducing local recurrence.
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Affiliation(s)
- Katharina Lucas
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
- Department of Visceral, Thoracic, Vascular Surgery and Angiology, City Hospital Triemli, Birmensdorferstrasse 497, 8063 Zürich, Switzerland
| | - Nathaniel Melling
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
| | - Anastasios D. Giannou
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
| | - Matthias Reeh
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
| | - Oliver Mann
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
| | - Thilo Hackert
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
| | - Jakob R. Izbicki
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
| | - Daniel Perez
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
- Department of General and Visceral Surgery, Asklepios Hospital Altona, Paul-Ehrlich-Straße 1, 22763 Hamburg, Germany
| | - Julia K. Grass
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (K.L.); (N.M.); (A.D.G.); (M.R.); (O.M.); (T.H.); (J.R.I.); (D.P.)
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8
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Lei Y, Zhao ZM, Li YS. Assessment of the efficacy and safety of carbon nanoparticles-guided lymph node dissection in gastric cancer surgery: a systematic review and meta-analysis. Int J Clin Oncol 2023; 28:764-776. [PMID: 37099219 DOI: 10.1007/s10147-023-02333-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/20/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND To investigate the efficacy and safety of lymph nodes (LNs) dissection guided by carbon nanoparticles (CNs) in gastric cancer (GC) surgery. MATERIALS AND METHODS We searched electronic databases such as PubMed, Web of Science, Embase, Cochrane Library, and Scopus for relevant articles up to September 2022 and collected all studies comparing the CNs group with blank controls group on the efficacy and safety of LN dissection in gastrectomy. A pooled analysis of the collected data was performed, including the number of retrieved LNs, the staining rate of LNs, the number of metastatic LNs dissection, various intraoperative outcomes, and postoperative complications. RESULTS A total of 9 studies including 1770 participants (502 in the CNs group and 1268 in the control group) were included. As compared to the blank control group, the CNs group detected 10.46 more LNs in each patient (WMD = 10.46, 95% CI: 6.63 ~ 14.28, p < 0.00001, I2 = 91%), and also significantly more metastatic LNs (WMD = 2.63, 95% CI: 1.43 ~ 3.83, p < 0.0001, I2 = 41%). However, there was no significant difference in the rate of metastatic LNs between the CNs and control groups (OR = 1.37, 95% CI: 0.94 ~ 2.00, P = 0.1, I2 = 89%). In addition, there was no increase in operative time, intraoperative blood loss, and postoperative complications associated with CNs-guided gastrectomy. CONCLUSION CNs-guided gastrectomy is safe and effective, and can increase the efficiency of LN dissection without increasing the risk of surgery.
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Affiliation(s)
- Yun Lei
- Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, No. 4 Chongshan East Road, Shenyang, 110032, Liaoning Province, China
| | - Zhe-Ming Zhao
- Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, No. 4 Chongshan East Road, Shenyang, 110032, Liaoning Province, China
| | - Yong-Shuang Li
- Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, No. 4 Chongshan East Road, Shenyang, 110032, Liaoning Province, China.
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9
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Das A, Adhikari S, Deka D, Baildya N, Sahare P, Banerjee A, Paul S, Bisgin A, Pathak S. An Updated Review on the Role of Nanoformulated Phytochemicals in Colorectal Cancer. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040685. [PMID: 37109643 PMCID: PMC10143464 DOI: 10.3390/medicina59040685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023]
Abstract
The most common cancer-related cause of death worldwide is colorectal cancer. It is initiated with the formation of polyps, which further cause the development of colorectal cancer in multistep phases. Colorectal cancer mortality is high despite recent treatment breakthroughs and a greater understanding of its pathophysiology. Stress is one of the major causes of triggering different cellular signalling cascades inside the body and which might turn toward the development of cancer. Naturally occurring plant compounds or phytochemicals are being studied for medical purposes. Phytochemicals' benefits are being analyzed for inflammatory illnesses, liver failure, metabolic disorders, neurodegenerative disorders, and nephropathies. Cancer treatment with fewer side effects and better outcomes has been achieved by combining phytochemicals with chemotherapy. Resveratrol, curcumin, and epigallocatechin-3-gallate have been studied for their chemotherapeutic and chemopreventive potentiality, but hydrophobicity, solubility, poor bioavailability, and target selectivity limit the clinical uses of these compounds. The therapeutic potential is maximized by utilizing nanocarriers such as liposomes, micelles, nanoemulsions, and nanoparticles to increase phytochemical bioavailability and target specificity. This updated literature review discusses the clinical limitations, increased sensitivity, chemopreventive and chemotherapeutic effects, and the clinical limitations of the phytochemicals.
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Affiliation(s)
- Alakesh Das
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Chennai 603103, India
| | - Suman Adhikari
- Department of Chemistry, Govt. Degree College, Dharmanagar 799253, India
| | - Dikshita Deka
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Chennai 603103, India
| | | | - Padmavati Sahare
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus UNAM 3001, Juriquilla 76230, Querétaro, Mexico
| | - Antara Banerjee
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Chennai 603103, India
| | - Sujay Paul
- Tecnologico de Monterrey, School of Engineering and Sciences, Campus Queretaro, San Pablo 76130, Querétaro, Mexico
| | - Atil Bisgin
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Medical Genetics Department of Medical Faculty, Cukurova University, Adana 01330, Turkey
- InfoGenom RD Laboratories of Cukurova Technopolis, Adana 01330, Turkey
| | - Surajit Pathak
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Chennai 603103, India
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10
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Ma J, Wang G, Ding X, Wang F, Zhu C, Rong Y. Carbon-Based Nanomaterials as Drug Delivery Agents for Colorectal Cancer: Clinical Preface to Colorectal Cancer Citing Their Markers and Existing Theranostic Approaches. ACS OMEGA 2023; 8:10656-10668. [PMID: 37008124 PMCID: PMC10061522 DOI: 10.1021/acsomega.2c06242] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/23/2023] [Indexed: 06/19/2023]
Abstract
Colorectal cancer (CRC) is one of the universally established cancers with a higher incidence rate. Novel progression toward cancer prevention and cancer care among countries in transition should be considered seriously for controlling CRC. Hence, several cutting edge technologies are ongoing for high performance cancer therapeutics over the past few decades. Several drug-delivery systems of the nanoregime are relatively new in this arena compared to the previous treatment modes such as chemo- or radiotherapy to mitigate cancer. Based on this background, the epidemiology, pathophysiology, clinical presentation, treatment possibilities, and theragnostic markers for CRC were revealed. Since the use of carbon nanotubes (CNTs) for the management of CRC has been less studied, the present review analyzes the preclinical studies on the application of carbon nanotubes for drug delivery and CRC therapy owing to their inherent properties. It also investigates the toxicity of CNTs on normal cells for safety testing and the clinical use of carbon nanoparticles (CNPs) for tumor localization. To conclude, this review recommends the clinical application of carbon-based nanomaterials further for the management of CRC in diagnosis and as carriers or therapeutic adjuvants.
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Affiliation(s)
- Jiheng Ma
- Department
of Oncology, Danyang Hospital of Traditional
Chinese Medicine, Zhenjiang 212300, Jiangsu Province, China
| | - Guofang Wang
- Department
of Oncology, Danyang Hospital of Traditional
Chinese Medicine, Zhenjiang 212300, Jiangsu Province, China
| | - Xiaoyu Ding
- Department
of Oncology, Danyang Hospital of Traditional
Chinese Medicine, Zhenjiang 212300, Jiangsu Province, China
| | - Fulin Wang
- Department
of Oncology, Danyang Hospital of Traditional
Chinese Medicine, Zhenjiang 212300, Jiangsu Province, China
| | - Chunning Zhu
- Department
of Oncology, Danyang Hospital of Traditional
Chinese Medicine, Zhenjiang 212300, Jiangsu Province, China
| | - Yunxia Rong
- Department
of Oncology, Danyang Hospital of Traditional
Chinese Medicine, Zhenjiang 212300, Jiangsu Province, China
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Hegde M, Naliyadhara N, Unnikrishnan J, Alqahtani MS, Abbas M, Girisa S, Sethi G, Kunnumakkara AB. Nanoparticles in the diagnosis and treatment of cancer metastases: Current and future perspectives. Cancer Lett 2023; 556:216066. [PMID: 36649823 DOI: 10.1016/j.canlet.2023.216066] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/31/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Metastasis accounts for greater than 90% of cancer-related deaths. Despite recent advancements in conventional chemotherapy, immunotherapy, targeted therapy, and their rational combinations, metastatic cancers remain essentially untreatable. The distinct obstacles to treat metastases include their small size, high multiplicity, redundancy, therapeutic resistance, and dissemination to multiple organs. Recent advancements in nanotechnology provide the numerous applications in the diagnosis and prophylaxis of metastatic diseases, including the small particle size to penetrate cell membrane and blood vessels and their capacity to transport complex molecular 'cargo' particles to various metastatic regions such as bones, brain, liver, lungs, and lymph nodes. Indeed, nanoparticles (NPs) have demonstrated a significant ability to target specific cells within these organs. In this regard, the purpose of this review is to summarize the present state of nanotechnology in terms of its application in the diagnosis and treatment of metastatic cancer. We intensively reviewed applications of NPs in fluorescent imaging, PET scanning, MRI, and photoacoustic imaging to detect metastasis in various cancer models. The use of targeted NPs for cancer ablation in conjunction with chemotherapy, photothermal treatment, immuno therapy, and combination therapy is thoroughly discussed. The current review also highlights the research opportunities and challenges of leveraging engineering technologies with cancer cell biology and pharmacology to fabricate nanoscience-based tools for treating metastases.
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Affiliation(s)
- Mangala Hegde
- Cancer Biology Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, 781039, Assam, India
| | - Nikunj Naliyadhara
- Cancer Biology Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, 781039, Assam, India
| | - Jyothsna Unnikrishnan
- Cancer Biology Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, 781039, Assam, India
| | - Mohammed S Alqahtani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia; BioImaging Unit, Space Research Centre, Michael Atiyah Building, University of Leicester, Leicester, LE1 7RH, UK
| | - Mohamed Abbas
- Electrical Engineering Department, College of Engineering, King Khalid University, Abha, 61421, Saudi Arabia; Computers and Communications Department, College of Engineering, Delta University for Science and Technology, Gamasa, 35712, Egypt
| | - Sosmitha Girisa
- Cancer Biology Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, 781039, Assam, India
| | - Gautam Sethi
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117600, Singapore.
| | - Ajaikumar B Kunnumakkara
- Cancer Biology Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, 781039, Assam, India.
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12
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Zhu C, Wang J, Wu Q, Da M. Safety and Efficacy of Carbon Nanoparticle-Labeled Lymph Node Dissection in Radical Resection of Gastric Cancer: A Systematic Review and Meta-Analysis. Technol Cancer Res Treat 2023; 22:15330338231154094. [PMID: 36877933 PMCID: PMC9947691 DOI: 10.1177/15330338231154094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Objective: In this meta-analysis, we investigated the safety and efficacy of carbon nanoparticle (CNP) trace-guided lymph node (LN) dissection during radical gastrectomy. Methods: Literature on CNP tracing compared with non-CNP tracing in radical gastric cancer (GC) surgery was searched from PubMed, EMBASE (Ovid platform), Web of Science, and the Cochrane Library from the establishment of the library until October 2022. This meta-analysis was performed according to the preferred reporting items for systematic reviews and meta-analysis guidelines. Available data regarding the number of LNs dissected, number of metastatic LNs dissected, other surgical outcomes, and postoperative complications were analyzed in a pooled manner. Stata software (version 12.0) was used for the present meta-analysis. Results: This analysis included 7 studies with a total of 1827 GC patients (551 and 1276 in the CNP and non-CNP groups, respectively). The results of the meta-analysis showed that the CNP group had more intraoperative LNs detected [weighted mean difference (WMD) = 6.67, 95% confidence interval (CI): 3.71-9.62], more LN metastases (WMD = 1.60, 95% CI: 0.09-3.12), and less intraoperative bleeding (WMD = 11.33, 95% CI: 6.30-16.37) than the non-CNP group, all with statistically significant differences (P < .05). For postoperative complications (odds ratio [OR] = 0.88, 95% CI: 0.52-1.48) and operative time (WMD = -11.60, 95% CI: -40.53-17.34), there was no statistically significant difference between the 2 groups (P > 0.05). Conclusions: CNP was a significant tracer for the LNs of GC. It increased the number of LNs harvested while reducing intraoperative blood loss, without increasing the operative time or postoperative complications. CNP tracer-guided lymphadenectomy is considered safe and effective for gastrectomy.
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Affiliation(s)
- Chenglou Zhu
- The Frist School of Clinical Medicine, 12426Lanzhou University, Lanzhou, China
| | - Junhong Wang
- The Frist School of Clinical Medicine, 12426Lanzhou University, Lanzhou, China
| | - Qiong Wu
- The Frist School of Clinical Medicine, 12426Lanzhou University, Lanzhou, China
| | - Mingxu Da
- The Frist School of Clinical Medicine, 12426Lanzhou University, Lanzhou, China.,Department of Surgical Oncology, 91589Gansu Provincial Hospital, Lanzhou, China
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13
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Liu F, Peng D, Liu XY, Liu XR, Li ZW, Wei ZQ, Wang CY. The effect of carbon nanoparticles staining on lymph node tracking in colorectal cancer: A propensity score matching analysis. Front Surg 2023; 10:1113659. [PMID: 36936663 PMCID: PMC10014567 DOI: 10.3389/fsurg.2023.1113659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose The aim of this study was to evaluate the effect of carbon nanoparticles staining (CNS) on colorectal cancer (CRC) surgery, lymph node tracing and postoperative complications using propensity score matching (PSM). Method Patients who were diagnosed with CRC and underwent surgery were retrospectively collected from a single clinical center from Jan 2011 to Dec 2021. Baseline characteristics, surgical information and postoperative information were compared between the CNS group and the non-CNS group. PSM was used to eliminate bias. Results A total of 6,886 patients were enrolled for retrospective analysis. There were 2,078 (30.2%) patients in the CNS group and 4,808 (69.8%) patients in the non-CNS group. After using 1: 1 ratio PSM to eliminate bias, there were 2,045 patients left in each group. Meanwhile, all of their baseline characteristics were well matched and there was no statistical significance between the two groups (P > 0.05). In terms of surgical information and short-term outcomes, the CNS group had less intraoperative blood loss (P < 0.01), shorter operation time (P < 0.01), shorter postoperative hospital stay (P < 0.01), less metastatic lymph nodes (P = 0.013), more total retrieved lymph nodes (P < 0.01), more lymphatic fistula (P = 0.011) and less postoperative overall complications (P < 0.01) than the non-CNS group before PSM. After PSM, the CNS group had less intraoperative blood loss (P = 0.004), shorter postoperative hospital stay (P < 0.01) and more total retrieved lymph nodes (P < 0.01) than the non-CNS group. No statistical difference was found in other outcomes (P > 0.05). Conclusion Preoperative CNS could help the surgeons detect more lymph nodes, thus better determining the patient's N stage. Furthermore, it could reduce intraoperative blood loss and reduce the hospital stay.
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14
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Huang B, Jin L, Peng T, Fei Z. Colorectal Cancer Lymph Node Detection and Anastomotic Safety of Using Carbon Nano-Tracer Following Minimally Invasive Radical Surgery. J Biomed Nanotechnol 2022. [DOI: 10.1166/jbn.2022.3408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: The goal of this study is to examine the impact of rectal submucosal injection of nano-carbon suspension injection following neoadjuvant therapy for middle and low rectal cancer on lymph node identification and anastomotic safety. Methods: 45 patients with intermediate-to-low
grade rectal cancer admitted to the Ningbo Medical Center Lihuili Hospital between March 2019 and March 2022 had their medical records reviewed retrospectively. Patients in case group were injected with nanocarbon suspension under an anoscope into the rectal submucosa patients in control group
were not injected with nanocarbon suspension. The lymph node identification and anastomotic consequences were then compared. Results: There were statistically significant differences between the two groups in the average number of lymph nodes discovered in the observation group and
the percentage of patients with more than 12 lymph nodes detected. The percentage of patients with lymph node metastases did not significantly. The rates of complications such leakage, hemorrhage, stenosis, and abscesses around the anastomosis were similar in both groups. Conclusion:
Nano carbon lymph node tracking is a safe, simple, and easy-to-operate method for increasing the number of lymph nodes detected in surgical specimens of middle and low rectal cancer after neoadjuvant therapy.
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Affiliation(s)
- Bin Huang
- Department of Anorectal Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, 315040, China
| | - Liangbin Jin
- Department of Anorectal Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, 315040, China
| | - Tao Peng
- Department of Anorectal Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, 315040, China
| | - Zhenglei Fei
- Department of Anorectal Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, 315040, China
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15
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Liu L, Li X, Hu Y, Sun J, Chen J, Xiao D, Wu W, Xie B. Lymph Node Cluster Dissection After Carbon Nanoparticles Injection Enhances the Retrieval Number in Colorectal Cancer. J Biomed Nanotechnol 2022. [DOI: 10.1166/jbn.2022.3397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
For colorectal cancer patients, NCCN recommended that at least 12 lymph nodes should be detected since the number and metastases status of lymph nodes played an important role in the treatment and prognostic. Carbon nanoparticles have been proved to be an efficient lymph node tracer.
Faced with the clinical problem of insufficient lymph nodes in colorectal cancer, we proposed a lymph node cluster (D3, D2 and D1) dissection method combined with carbon nanoparticle injection. In our study, patients were divided into 2 groups (CNP and control). All lymph nodes of each patient
were collected and made into hematoxylin-eosin sections to observe their size, staining appearance and metastasis status under the microscope. As a result, the total lymph nodes in CNP group were greatly higher than control group (51.45 vs. 29.62, P = 0.000), especially micro LNs and
positive micro LNs. Compared with D2 and D1 stations, fewer lymph nodes were found in D3, and it was the same for cancer metastasis status. In CNP group, most lymph nodes got black for quick visualization. In conclusion, lymph node cluster dissection combined with carbon nanoparticles could
enhance the number of lymph node retrieval.
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Affiliation(s)
- Lu Liu
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Xi Li
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Yulin Hu
- Department of Pathology, Chenzhou First People’s Hospital, Chenzhou, Hunan, 423000, China
| | - Jingyue Sun
- Department of Pathology, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Central South University, Changsha, Hunan, 410008, China
| | - Jielin Chen
- Department of Pathology, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Central South University, Changsha, Hunan, 410008, China
| | - Desheng Xiao
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Wei Wu
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Bin Xie
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
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16
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Tian Y, Yang P, Lin Y, Hu Y, Deng H, Ma W, Guo H, Liu Y, Zhang Z, Ding P, Li Y, Fan L, Zhang Z, Wang D, Zhao Q. Assessment of Carbon Nanoparticle Suspension Lymphography-Guided Distal Gastrectomy for Gastric Cancer. JAMA Netw Open 2022; 5:e227739. [PMID: 35435969 PMCID: PMC9016491 DOI: 10.1001/jamanetworkopen.2022.7739] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Carbon nanoparticle suspension injection (CNSI) can be used to visualize lymph node (LN) drainage in gastric cancer. The tracing and diagnostic value of carbon nanoparticle suspension lymphography-guided distal gastrectomy for gastric cancer has not been thoroughly reported. OBJECTIVE To compare the number of lymph nodes identified in patients with gastric cancer receiving a CNSI vs no injection. DESIGN, SETTING, AND PARTICIPANTS This is a retrospective cohort study including patients with clinical T1 to T4 disease who underwent laparoscopic or robotic distal gastrectomy. Data from a cohort of 1225 patients at the Fourth Hospital of Hebei Medical University (Shijiazhuang, China) from November 2019 to February 2021 were analyzed. Patients were divided into the CNSI group and conventional group after 1:1 propensity matching analysis. The mean number of LNs detected was compared between groups, and the diagnostic role of CNSI was analyzed in the CNSI group. Statistical analysis was performed from May to July 2021. EXPOSURE CNSI was peritumorally injected under an endoscope 1 day before surgery in the CNSI group, and the conventional group did not receive any treatment before surgery. MAIN OUTCOMES AND MEASURES The main outcome was the number of LNs detected. Gastrectomy with systematic D1+ (ie, stations 1, 3, 4sb, 4d, 5, 6, and 7) or D2 (ie, all D1 stations, plus 8a, 9, 11p, and 12a) lymphadenectomy was performed. Black-stained LNs and nonblack-stained LNs were examined separately in the CNSI group. RESULTS A total of 312 consecutive patients (mean [SD] age, 56.7 [10.4] years; 216 [69.2%] men) who underwent distal gastrectomy were enrolled, including 78 patients in the CNSI group, and another 78 patients determined from 1:1 propensity score matching, making an overall cohort size of 156 patients. The mean (SD) number of LNs detected in the CNSI group was 59.6 (21.4), which was significantly higher than that in the conventional group (30.0 [11.3] LNs; P < .001). In the CNSI group, the mean (SD) number of LNs detected at black-stained LN stations was significantly higher than that at nonstained LN stations (9.2 [6.1] LNs per station vs 3.5 [3.2] LNs per station; P < .001). For black-stained LN stations, the sensitivity was 97.8% (95% CI, 91.6%-99.6%), specificity was 38.1% (95% CI, 34.2%-42.3%), positive predictive value was 20.1% (95% CI, 16.6%-24.2%), and negative predictive value was 99.1% (95% CI, 96.4%-99.8%); for the black-stained LNs, sensitivity was 97.6% (95% CI, 95.3%-98.8%), specificity was 35.4% (95% CI, 33.9%-36.8%), positive predictive value was 11.6% (95% CI, 10.5%-12.8%), and negative predictive value was 99.4% (95% CI, 98.8%-99.7%). CONCLUSIONS AND RELEVANCE These findings suggest that CNSI was associated with facilitating the dissection of all positive LNs, which could improve surgical quality. Carbon nanoparticle suspension-guided lymphography may be an alternative to conventional systematic lymphadenectomy for distal gastrectomy.
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Affiliation(s)
- Yuan Tian
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Peigang Yang
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yecheng Lin
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yiyang Hu
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huiyan Deng
- Department of Pathology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wenqian Ma
- Department of Endoscopy, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Honghai Guo
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yang Liu
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ze Zhang
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Pingan Ding
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yong Li
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liqiao Fan
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhidong Zhang
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dong Wang
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qun Zhao
- Third Surgery Department, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Zhou J, Chen L, Chen L, Zeng X, Zhang Y, Yuan Y. Emerging role of nanoparticles in the diagnostic imaging of gastrointestinal cancer. Semin Cancer Biol 2022; 86:580-594. [DOI: 10.1016/j.semcancer.2022.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/11/2022]
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18
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Zhao K, Shan BQ, Gao YP, Xu JY. Role of carbon nanotracers in lymph node dissection of advanced gastric cancer and the selection of preoperative labeling time. World J Clin Cases 2022; 10:870-881. [PMID: 35127902 PMCID: PMC8790434 DOI: 10.12998/wjcc.v10.i3.870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/19/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of gastric cancer is high. The number of dissected lymph nodes was an independent factor affecting prognosis. Although preoperative labeling is helpful in lymph nodes resection, there are no guidelines for when to perform preoperative labeling.
AIM To investigate the role of nanocarbon in lymph node dissection during gastrectomy, and to discuss the relationship between the timing of preoperative injection of carbon nanoparticles and the extent of lymph node dissection.
METHODS A prospective analysis was performed on the clinical data of 307 patients with advanced gastric cancer who underwent laparoscopic surgery in the General Surgery Department of Weifang People’s Hospital between June 2018 and February 2021. The patients were randomly divided into experimental group and control group based on whether they received preoperative nanocarbon injection or not. The experimental group was divided into different groups according to the preoperative labeling time. The number of dissected lymph nodes and the number of lymph nodes with black staining were compared in each group after surgery, and the role of nanocarbon in the number of dissected lymph nodes, pathological staging, and the relationship with prognosis were discussed.
RESULTS The average number of dissected lymph nodes in the experimental group was higher than that in the control group. In the experimental group, the number of lymph node dissections and number of black-staining lymph nodes in the nanocarbon-labeling group at 2 d and 1 d before surgery were higher than in the labeling group on the day before surgery (P < 0.05).
CONCLUSION Preoperative nanocarbon labeling can safely and effectively guide lymph node dissection. To improve the detection rate of lymph nodes is conducive to subsequent comprehensive anti-tumor therapy.
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Affiliation(s)
- Kai Zhao
- Department of General Surgery, WFPH, Weifang 261400, Shandong Province, China
| | - Bao-Qiang Shan
- Department of General Surgery, WFPH, Weifang 261400, Shandong Province, China
| | - Yan-Peng Gao
- Department of General Surgery, WFPH, Weifang 261400, Shandong Province, China
| | - Jia-You Xu
- Department of General Surgery, WFPH, Weifang 261400, Shandong Province, China
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19
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Feng Y, Yang K, Sun HH, Liu YP, Zhang D, Zhao Y, Shi W, Lu GF, Zhang ZY, Jia A, He SX, Li HX. Value of preoperative gastroscopic carbon nanoparticles labeling in patients undergoing laparoscopic radical gastric cancer surgery. Surg Oncol 2021; 38:101628. [PMID: 34174770 DOI: 10.1016/j.suronc.2021.101628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/07/2021] [Accepted: 06/11/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVES Lymph node metastasis is crucial for gastric cancer. We aim to explore the value of preoperative gastroscopic carbon nanoparticles labeling in patients undergoing laparoscopic radical gastric cancer surgery. METHODS 1199 cases undergoing laparoscopic radical gastric cancer surgery were retrospectively analyzed. 214 cases received preoperative gastroscopic carbon nanoparticles labeling. The number of total lymph nodes detected, positive lymph nodes, N staging, and operation time were analyzed. RESULTS The patients received carbon nanoparticles labeling had more total lymph nodes detected (27.9 ± 6.5 vs 22.2 ± 4.0; P < 0.001) and shorter operation time (185.9 ± 27.8min vs 218.7 ± 69.2min; P < 0.001) compared with the control group. In addition, preoperative endoscopic carbon nanoparticles labeling improved the diagnosis rate of synchronous multiple gastric cancer (2.8% vs 0.4%; P < 0.001). CONCLUSIONS Preoperative endoscopic carbon nanoparticles tracer labeling is of great value in patients undergoing laparoscopic radical gastric cancer surgery. It shortens the operation time, increases the number of total lymph nodes detected for more accurate pathological TNM staging, and finds some cases of synchronous multiple gastric cancer.
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Affiliation(s)
- Yun Feng
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Kui Yang
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Huan-Huan Sun
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Ya-Ping Liu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Dan Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Yan Zhao
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Wen Shi
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Gui-Fang Lu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Zhi-Yong Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Ai Jia
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China
| | - Shui-Xiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China.
| | - Hong-Xia Li
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, 710061, PR China.
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Application of Carbon Nanoparticles in Neck Dissection of Clinically Node-Negative Papillary Thyroid Carcinoma. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6693585. [PMID: 33969124 PMCID: PMC8084638 DOI: 10.1155/2021/6693585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/09/2021] [Accepted: 03/29/2021] [Indexed: 11/22/2022]
Abstract
Purpose The purpose of this retrospective study was to evaluate the advantages of carbon nanoparticles in neck dissection and to conclude its application in the treatment of clinically node-negative papillary thyroid carcinoma (CN0PTC). Methods As a retrospective cohort study, we divided the enrolled patients into two groups, the carbon nanoparticle (CN) group and the control group according to the usage of CN. In the CN group, CN was applied to reveal drainage lymph nodes and the picked LNs were sent for fast frozen testing. If metastasis exits, modified radical lateral lymph node dissection (LLND) was performed. For both groups, prophylactic central lymph node dissection was routinely done. Finally, the demographic information, tumor characteristics, postoperative pathological results, and laboratory data were collected for analysis. Results A total of 61 CN0PTC were enrolled in this study, 33 in the CN group and 28 in the control group. The black-stained rate for CN was 29/40 (72.5%) with a positive prediction rate of 34.5%. The mainly black-stained region in the lateral neck was level III and possesses the highest lymph node ratio (17.5%). The metastasis that occurred in level VI was 30% and 11.8% in the CN and control groups, respectively (p = 0.058). During the available follow-up, no one showed recurrence. Statistical analysis showed that the CN suspension can significantly reduce the risk of damage to the parathyroid gland (p = 0.001 for hypocalcemia, <0.05; p = 0.047 for hypoparathyroidism, <0.05). Conclusion The lateral neck metastasis in patients with papillary thyroid microcarcinoma in clinical stage cT1aN0 is not rare. CN can help surgeons to distinguish the real person who actually needs LLND. In prophylactic CLND, CN acts as a tracer which makes the parathyroid gland more identifiable and avoids risks of injuries to nerves and glands.
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Li L, Fu J, Wang X, Chen Q, Zhang W, Cao Y, Ran H. Biomimetic "Nanoplatelets" as a Targeted Drug Delivery Platform for Breast Cancer Theranostics. ACS APPLIED MATERIALS & INTERFACES 2021; 13:3605-3621. [PMID: 33449625 DOI: 10.1021/acsami.0c19259] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Breast cancer is a major threat to health and lives of females. Biomimetic nanotechnology brought brighter hope for early diagnosis and treatment of breast cancer. Here, we proposed a platelet (PLT) membrane-derived strategy for enhanced photoacoustic (PA)/ultrasonic (US)/fluorescence (FL) multimodal imaging and augmented synergistic photothermal/chemotherapeutic efficacy in tumor cells. A PA imaging contrast and photothermal agent, nanocarbons (CNs), a chemotherapeutic and FL material, doxorubicin (DOX), and perfluoropentane (PFP) were coencapsulated into the poly(lactic-co-glycolic) acid (PLGA) skeletons. Then, the PLT membranes were coated onto the PLGA NPs, which were named as "nanoplatelets" (DOX-PFP-CNs@PLGA/PM NPs). The "nanoplatelets", which conserved the structural advantages and inherent properties of PLTs, could not only escape from phagocytosis of macrophages but also actively targeted tumor cells by the way of antigen-antibody interactions between P-selectin on the PM and CD44 receptors of the tumor cells. With CNs and DOX loaded in, these "nanoplatelets" could serve as an excellent contrast agent for PA/FL imaging. Under laser irradiation, the "nanoplatelets" could turn light energy into heat energy. The laser-triggered photothermal effect, on the one hand, could ablate the tumor cells immediately, and on the other hand, could initiate the optical droplet vaporization of PFP, which subsequently enhanced US imaging and promoted the discharge of encapsulated DOX from the "nanoplatelets" for remarkably strengthening photothermal therapeutic power in turn. In this work, as compared with the bare drug-loaded nanoparticles, the "nanoplatelets" exhibited much more accumulation in the tumor cells, demonstrating superior multimodal imaging capability and preferable synergistic therapeutic performance. In conclusion, the "nanoplatelets" could serve as contrast agents for US imaging and PA imaging to guide the therapy. What is more, the bioinspired PLT-derived, targeted, and nontoxic "nanoplatelets", which were exploited for multimodal PA/US/FL imaging-guided synergistic photothermal/chemo therapy, will be of great value to breast cancer theranostics in the days to come.
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Affiliation(s)
- Lin Li
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Ultrasound Department of the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China
| | - Jian Fu
- Vascular Surgery Department of the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China
| | - Xingyue Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Ultrasound Department of the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China
| | - Qiaoqi Chen
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Ultrasound Department of the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China
| | - Wei Zhang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Ultrasound Department of the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China
| | - Yang Cao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Ultrasound Department of the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China
| | - Haitao Ran
- Chongqing Key Laboratory of Ultrasound Molecular Imaging, Ultrasound Department of the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China
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Liu P, Tan J, Tan Q, Xu L, He T, Lv Q. Application of Carbon Nanoparticles in Tracing Lymph Nodes and Locating Tumors in Colorectal Cancer: A Concise Review. Int J Nanomedicine 2020; 15:9671-9681. [PMID: 33293812 PMCID: PMC7719328 DOI: 10.2147/ijn.s281914] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023] Open
Abstract
Background Accurate lymph node (LN) staging has considerably prognostic and therapeutic value in patients with colorectal cancer (CRC). The purpose of this study is to evaluate the feasibility of applying carbon nanoparticles (CNPs) to track LN metastases in CRC. Methods Two researchers independently screened publications in PubMed, EMBASE, Cochrane and Ovid MEDLINE databases. The keywords were (carbon nanoparticles OR activated carbon nanoparticles) AND (colon cancer OR rectal cancer OR colorectal cancer). Titles and abstracts of the articles were meticulously read to rule out potential publications. Next, full texts of the ultimately obtained eligible publications were retrieved and analyzed in detail. Results The search produced 268 publications, and 140 abstracts were identified after a bibliographic review. Finally, 20 studies relevant to our subject were obtained; however, only 14 papers met our inclusion criteria and were included for final review. All studies included have compared the control group with carbon nanoparticles group (control group, defined as nontattooed group; and carbon nanoparticles group, defined as administering carbon nanoparticles during surgery) for their efficacy in intraoperative detecting and positioning. After analysis, appreciably less amount of bleeding (3/5 trials), shorter operation time (2/4 trials), and shorter time to detect lesions and dissect LNs (2/2 trials) were revealed in CNPs group compared to control group. Thirteen studies have recorded the numbers of the harvested LNs in both groups; meanwhile, CNPs group shows superiority to control group in LN retrieval as well (11/13 trials), which also could effectively aid in locating and harvesting more LNs with diameter below 5 mm. Conclusion The tracing technique for CNPs is a safe and useful strategy both in localizing tumor and tracing LNs in CRC surgery. But there is still a need for more randomized controlled trials to further establish its contribution to patient survival.
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Affiliation(s)
- Pengcheng Liu
- Department of Breast Surgery, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Jie Tan
- Department of Orthopaedic Surgery & Orthopaedic Institute, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Qiuwen Tan
- Department of Breast Surgery, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Li Xu
- Department of Breast Surgery, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Tao He
- Department of Breast Surgery, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Qing Lv
- Department of Breast Surgery, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
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Li J, Deng X, Wang L, Liu J, Xu K. Clinical application of carbon nanoparticles in lymphatic mapping during colorectal cancer surgeries: A systematic review and meta-analysis. Dig Liver Dis 2020; 52:1445-1454. [PMID: 32912769 DOI: 10.1016/j.dld.2020.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the overall performance of carbon nanoparticles (CNs) for detecting lymph nodes (LNs) and node metastasis during colorectal cancer surgery. METHODS The English and Chinese literature was searched until 29 April 2020. Studies were included if they were randomized controlled trials (RCTs) for colorectal resection and LN dissection that compared the use of CNs with a blank control in colorectal cancer surgery. Quality assessment and data extraction were performed, and a meta-analysis was conducted using ReviewManager 5.3 and Stata 15.1 software. RESULTS A total of 17 RCTs comprising 1241 patients were included for analysis. Compared with the outcomes of the blank controls, the use of CNs resulted in an average of 5.21 more LNs per patient (weighted mean difference = 5.21, 95% confidence interval [CI] = 4.14-6.29, p < 0.001) and a 68% higher detection rate of micro LNs (relative risk [RR] = 1.68, 95% CI = 1.38-2.04, p < 0.001). In addition, more metastatic LNs were identified in stained nodes (RR = 1.56, 95% CI = 1.40-1.75, p < 0.001), but the total detection rate of metastatic nodes did not differ between the groups. CONCLUSION CN is an effective lymphatic tracer in colorectal cancer surgeries. Further studies with larger sample sizes are needed to validate these findings.
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Affiliation(s)
- Jiahuan Li
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiaoling Deng
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Liyu Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jingsong Liu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Keshu Xu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Maffioli A, Danelli P. Carbon nanoparticles application during colorectal cancer surgery: Updates from China. Dig Liver Dis 2020; 52:1443-1444. [PMID: 33097428 DOI: 10.1016/j.dld.2020.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Anna Maffioli
- University of Milan, Surgery Unit, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Piergiorgio Danelli
- University of Milan, Surgery Unit, ASST Fatebenefratelli Sacco, Milan, Italy
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