Analysis of 246 sentinel lymph node biopsies of patients with clinical primary breast cancer by application of carbon nanoparticle suspension

Yang, Shi‐Ming; Wei, Wensong; Jiang, Qi; Zhou, Yufeng; Qü, Wei; Tu, Jianhong; Ouyang, Qianwen; Zhou, Zhengming; Ding, Haolong; Xie, Congying

doi:10.1111/jog.13635

Cited by 13 publications

(7 citation statements)

References 13 publications

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“…In recent years, CNS has proven to be beneficial as a lymph node tracer that allows lymph nodes to be explored during surgery for breast cancer, thyroid cancer and gastric cancer 15,22,23 . For cervical cancer, the application of CNS was attempted with SLNB in a limited sample size of 40 patients in 2017, with DR of 95% (38/40), sensitivity of 100% (5/5) and NPV of 100% 12 .…”

Section: Discussionmentioning

confidence: 99%

“…A previous cervical cancer study showed that performing SLNB with CNS resulted in easy identification, with good lymphatic tracer effects, and results in increased lymph node retrieval 12 . CNS has been applied in early breast cancer and mid‐low rectal cancer, and has detection and predictive values for SLNBs 13‐15 . Its use in SLNB for cervical cancer is relatively new.…”

Section: Introductionmentioning

confidence: 99%

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Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Qian

Huiqing

et al. 2020

BJOG

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Objective To evaluate the clinical diagnostic validity of carbon nanoparticle suspension (CNS) in sentinel lymph node biopsy (SLNB) for assessing lymphatic spread of early‐stage cervical cancer. Design A prospective study. Setting and population 356 cases. Methods We enrolled 356 stage Ia2‐IIa2 cervical cancer patients to undergo SLNB using CNS, followed by systematic pelvic lymphadenectomy. All lymph node specimens were assessed using conventional histopathologic ± pathologic ultrastaging analyses. Main outcome measures Sentinel lymph node detection rate (DR), clinical diagnostic validity and various related factors were analysed. Results CNS identified 1456 SLNs in 325 patients. The overall SLN DR was 91.29%. A significantly higher DR was found for patients with tumours <20 mm (97.75% versus 71.91%; P < 0.001). Two patients had false‐negative results. SLNB with CNS had sensitivity of 96.65%, false‐negative rate (FNR) of 4.35% and negative predictive value (NPV) of 99.29%. Importantly, sensitivity (100%), NPV (100%) and FNR (0%) were improved when testing the subgroup of patients with tumours <20 mm (267 cases). There were no observed differences in DR based on pathological type or grade, stage, depth of stromal invasion, surgical approach, menopausal status or prior treatment with chemotherapy (P > 0.05). Conclusions Sentinel lymph node biopsy with CNS results in favourable DR, sensitivity and NPV for women with early‐stage cervical cancer with small tumour sizes. SLNB with CNS is safe, feasible and relatively effective for guiding precise surgical treatment of early‐stage cervical cancer. Tweetable abstract Sentinel lymph node biopsy with carbon nanoparticle suspension is safe and feasible for early‐stage cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Qian

Huiqing

et al. 2020

BJOG

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“…In China, CNSs have been widely used for the intraoperative identification of SLNs in various cancers, and have been found to have high detection rates and accuracy (45)(46)(47). CNSs can be used successfully for SLN identification in patients with early BC (39), and have been shown to have a higher SLNB success rate than nanocarbon staining (99.59%, with 97.06% accuracy and 93.22% sensitivity), and a lower false-negative rate (6.78%) (48). The detection rate of the CNS-alone method was lower than that of the ICG + MB method (98.3% vs. 100%); however, the difference was not significant (49).…”

Section: Discussionmentioning

confidence: 99%

Near-infrared laparoscopy with indocyanine green for axillary sentinel lymph node biopsy in early breast cancer: preliminary experience of a single unit

Yang¹,

Hu²,

Peng³

et al. 2021

Gland Surg

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Background: A sentinel lymph node biopsy (SLNB) is a routine procedure for axillary staging in cN0 breast cancer (BC) patients. Indocyanine green (ICG) fluorescence can detect sentinel lymph nodes with higher sensitivity than carbon nanoparticle suspension (CNS). The present study investigated the availability and benefits of a near-infrared (NIR) laparoscopy-assisted SLNB using ICG and carbon nanoparticle suspension as tracers.Methods: Forty patients with invasive BC, who had clinically negative axillary lymph nodes, participated in this observational study. ICG and CNS tracers were injected into the periareolar region simultaneously or sequentially. In the endoscopy-assisted group (n=20), the patients were given NIR laparoscopic SLNB based on ICG fluorescence and CNS staining. In the open-surgery group, the patients were given traditional SLNB using an open incision, and CNS tracers were injected into the same region as that in the endoscopyassisted group.Results: In the endoscopy-assisted group, lymphatic vessels and sentinel lymph nodes (SLNs) were successfully identified using ICG fluorescence imaging in most patients (19/20). The average number of SLNs removed was 2.85 (range, 1-4) in the endoscopy-assisted group, and 3.40 (range, 1-7) in the opensurgery group. There was no significant difference between the number of detected nodes (P=0.30). The patients who underwent endoscopy-assisted SLNBs had similar operating times, blood loss and hospital-stay lengths, but lower postoperative drainage volumes and higher satisfaction scores, as they did not have axillary incisions. Conclusions:The NIR laparoscopy-assisted ICG-guided technique is a feasible and surgeon-friendly method for SLNB with good efficacy and acceptable safety. When combined with CNS, more SLNs can be detected and dissected.

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“…After macrophage phagocytosis, the particles accumulate in the lymph nodes and dye them black . This unique selective accumulation of carbon nanoparticles is being used to make lymph node retrieval more efficient in certain types of surgery . The accompanying video (Video in the online Supporting Information) demonstrates the feasibility of using ACNS as a tracer to facilitate radical ALN dissection in laparoscopic rectal cancer surgery.…”

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confidence: 99%

Radical apical lymph node dissection guided by carbon nanoparticles in laparoscopic rectal cancer surgery – a video vignette

Zhou

Teng

et al. 2019

Colorectal Disease

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Analysis of 246 sentinel lymph node biopsies of patients with clinical primary breast cancer by application of carbon nanoparticle suspension

Abstract: Sentinel lymph node biopsy performed using the nanocarbon staining method is simple, easy and reliable, and it can be used to predict the axillary status of breast cancer in the early stage.

Cited by 13 publications

References 13 publications

Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early‐stage cervical cancer: a prospective study

Near-infrared laparoscopy with indocyanine green for axillary sentinel lymph node biopsy in early breast cancer: preliminary experience of a single unit

Radical apical lymph node dissection guided by carbon nanoparticles in laparoscopic rectal cancer surgery – a video vignette

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