ABSTRACT
Aim: To investigative the efficacy of carbon nanoparticles (CNs) to
identify the lymph nodes during radical surgery in colorectal cancer. Method: The
MEDLINE, EMBASE and Cochrane Library databases were searched electronically to identify
the studies that compared the use of CNs (CN group) with control group in
patients undergoing colorectal cancer radical surgery (from January 2009 to
November 2018). The primary outcome was the number of retrieved central lymph
nodes. Results: This meta-analysis identified 2 randomized controlled trials
and 5 non-randomized controlled trials. Compared with the control group, the CN
group resulted in an average of 7.16 more lymph nodes removed per patient (WMD
= 7.16, 95% CI = 3.76 to 10.57, p < 0.01), 7.26 minutes less required for retrieving lymph nodes (WMD = -7.26,
95% CI = -13.43 to -1.09, p = 0.02), and 15.1 ml less blood loss during operation (WMD = -15.11, 95% CI = -23.15
to -7.06, p < 0.01). Although
there was no significant difference in the metastatic lymph nodes between the
two groups (OR = 1.02, 95% CI = 0.79 to 1.31, p = 0.87), there was 1.45 times more metastatic lymph of the
stained nodes in CN group than in the control group (OR = 1.45, 95% CI = 1.13
to 1.85, p < 0.01). In addition,
lymph nodes less than 5 mm were detected significantly more in the CN group than in the control
group (OR = 2.15, 95% CI = 1.77 to 2.63, p < 0.01). Conclusions: The technique of CNs labeled lymph node staining in
curative colorectal carcinoma is easy and effective, which can improve the
retrieved number of lymph nodes, especially for nodes < 5 mm. The black
stained lymph node indicates higher risk of metastasis. Further high quality RCT is needed to verify
these conclusions.
Share and Cite:
Liu, M. , Shen, A. , Li, W. , Chen, L. , Chen, X. and Sun, H. (2019) Carbon Nanoparticles for Identifying Lymph Nodes during Surgery in Colorectal Cancer: A Meta-Analysis.
Journal of Cancer Therapy,
10, 134-145. doi:
10.4236/jct.2019.102010.