• 四川大學(xué)華西醫(yī)院 胸外科, 成都 610041;

目前，外科治療是非小細胞肺癌（non-small cell lung cancer, NSCLC）主要的治療方法之一。手術(shù)治療NSCLC 的標(biāo)準(zhǔn)術(shù)式是切除原發(fā)病灶和清掃肺門及縱隔淋巴結(jié)。盡管如此，早期肺癌患者術(shù)后的復(fù)發(fā)率仍然很高。其原因主要為兩個方面，一是清掃淋巴結(jié)不徹底；二是淋巴結(jié)微轉(zhuǎn)移（micrometastasis，MM）。納米炭混懸液的出現(xiàn)為我們解決上述問題提供了一種新的思路。納米炭混懸液是一種淋巴示蹤劑, 其主要作用是淋巴示蹤和靶向化療。淋巴示蹤使術(shù)中對淋巴結(jié)的清掃更徹底、更完全；靶向化療可以將術(shù)中殘留的腫瘤細胞進一步清除，以防止術(shù)后腫瘤復(fù)發(fā)。在胃腸道腫瘤和乳腺腫瘤的外科治療中，納米炭混懸液已得到較廣泛的應(yīng)用，作用和療效肯定；而納米炭混懸液在肺癌患者外科治療中的應(yīng)用是一種嘗試，它可在術(shù)中給胸外科醫(yī)生提供一定的幫助，使肺癌患者獲得更好的預(yù)后。現(xiàn)對納米炭混懸液的特點、應(yīng)用方法、在NSCLC 外科治療中的臨床應(yīng)用進行綜述。

引用本文： 張清峰,寇瑛琍. 納米炭混懸液在非小細胞肺癌外科治療中的臨床應(yīng)用. 中國胸心血管外科臨床雜志, 2012, 19(1): 73-76. doi: 復(fù)制

1. 　Izbicki JR, Passlick B, Hosch SB, et al. Mode of spread in the early phase of lymphatic metastasis in non-small-cell lung cancer： significance of nodal micrometastasis. J Thorac Cardiovasc Surg, 1996，112 (3)：623-630.
2. 　張建鵬, 鄒衛(wèi). 納米活性炭在腫瘤外科的應(yīng)用及在非小細胞肺癌手術(shù)中廓清淋巴結(jié)的意義.臨床肺科雜志，2009, 14(6)：791-792.
3. 　Toma A, Hagiwara A, Otsuji E，et al .Detection of sentinel lymphatic region with activated carbon particles in lymph node dissection for colorectal cancer.Gan To Kagaku Ryoho, 2002, 29(12): 2291-2293.
4. 　Busch FM, Sayegh ES．Roentgenographic visualization of human testicular lymphatics：a preliminary report.J Urol, 1963, 89(14)：106-110.
5. 　Cabanas RM．An approach for the treatment of penile carcinoma. Cancer, 1977, 39(2)：456-466.
6. 　Minamiya Y, Ogawa J. Benefit of sentinel lymph node mapping in non-small cell lung cancer. Ann Thorac Cardiovasc Surg, 2006, 12(6)：381-382．.
7. 　Minamiya Y, Ogawa J. The current status of sentinel lymph node mapping in non-small cell lung cancer. Ann Thorac Cardiovase Surg, 2005, 11(2)：67-72．.
8. 　Ono T, Minamiya Y, Ito M, et al. Sentinel node mapping and micrometastasis in patients with clinical stage IA non-small cell lung cancer.Interact Cardiovasc Thorac Surg, 2009, 9(4)：659-661.
9. 　李樹本, 何建行, 陳漢章, 等．納米炭在微創(chuàng)肺癌淋巴結(jié)清掃術(shù)中的應(yīng)用.中華腫瘤雜志, 2008, 30(3)：228-230．.
10. 　Liu CL, Yang TL, Chen BF. Sentinel lymph node mapping with emulsion of activated carbon particles in patients with pre-mastectomy diagnosis of intraductal carcinoma of the breast. J Chin Med Assoc, 2003, 66(7)：406-410.
11. 　鄭蘭東, 皇甫深強, 王新濤, 等. 活性炭微粒子在胃癌淋巴結(jié)清除中的應(yīng)用研究.中國現(xiàn)代普通外科進展, 2011, 14(9)：697-699.
12. 　鄧昊, 舒細記, 鎮(zhèn)鴻燕, 等．結(jié)直腸癌淋巴結(jié)微轉(zhuǎn)移對預(yù)后影響的意義．癌癥, 2003, 22(7)：762-766．.
13. 　Saha S, Wiese D, Badin J, et a1．Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging.Ann Surg Oncol, 2000, 7(2)：120-124．.
14. 　Melfi FM, Chella A, Menconi GF, et al. Intraoperative radioguided sentinel lymph node biopsy in non-small cell lung cancer. Eur J Cardiothorac Surg, 2003, 23(2)：214-220.
15. 　瞿歡, 張亞男. 納米炭在乳腺癌治療中的應(yīng)用.中國普通外科雜志, 2009, 18(5 )：495-497.
16. 　Akamo Y, Mizuno I, Takeyama H, et al. Chemotherapy targeting regional lymph nodes by gastric submucosal injection of liposomal adriamycin in patients with gastric cancer. Gan To Kagaku Ryoho, 1997, 24(12)：1712-1714.
17. 　Natsugoe S, Shimada M, Kumanohoso T, et al. Enhanced efficacy of bleomycin adsorbed on silica particles against lymph node metastasis in patients with esophageal cancer：a pilot study. Surgery, 1995, 117(6)：636-641.
18. 　Chen J，Wang L，Yao Q，et al. Drug concentrations in axillary lymph nodes after lymphatic chemotherapy on patients with breast cancer . Breast Cancer Res，2004，6(4)：R474-R477.
19. 　鮑傳慶, 許炳華, 沈曉明, 等．載藥納米炭在結(jié)腸癌手術(shù)中的應(yīng)用. 江蘇醫(yī)藥, 2007, 33(10)：1004-1005.
20. 　吳武軍, 曾健, 潘承恩．活性炭-表阿霉素混懸液對乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的治療作用．南方醫(yī)科大學(xué)學(xué)報, 2006, 26(12)：1812-1814．.
21. 　曲秋蓮, 張英鴿, 孫嵐. 納米活性炭對絲裂霉素C的吸附與緩釋性能研究.軍事醫(yī)學(xué)科學(xué)院院刊, 2004, 28(6)：552-554.
22. 　Okamoto K, Sawai K, Minato H, et al. Number and anatomical extent of lymph node metastases in gastric cancer： analysis using intra-lymph node injection of activated carbon particles (CH40). Jpn J Clin Oncol, 1999, 29(2)：74-77.
23. 　Yokota T, Saito T, Narushima Y, et al. Lymph-node staining with activated carbon CH40： a new method for axillary lymph-node dissection in breast cancer. Can J Surg, 2000, 43(3)： 191-196.
24. 　Ko K, Han BK, Jang KM, et al．The value of ultrasound-guided tattooing localization of nonpalpable breast lesions.Korean J Radiol, 2007, 8(4)：295-301．.
25. 　Tomizawa Y, Nakajima T, Kohno T, et al. Clinicopathological significance of Fhit protein expression in stage I non-small cell lung carcinoma. Cancer Res, 1998, 58(23)： 5478-5483.
26. 　高紅, 鄭春雷, 龐達. 載藥國產(chǎn)納米活性炭在胃癌根治術(shù)中的應(yīng)用.齊齊哈爾醫(yī)學(xué)院學(xué)報, 2010, 31(18)：2859-2862.
  1. 1. 　Izbicki JR, Passlick B, Hosch SB, et al. Mode of spread in the early phase of lymphatic metastasis in non-small-cell lung cancer： significance of nodal micrometastasis. J Thorac Cardiovasc Surg, 1996，112 (3)：623-630.
  2. 2. 　張建鵬, 鄒衛(wèi). 納米活性炭在腫瘤外科的應(yīng)用及在非小細胞肺癌手術(shù)中廓清淋巴結(jié)的意義.臨床肺科雜志，2009, 14(6)：791-792.
  3. 3. 　Toma A, Hagiwara A, Otsuji E，et al .Detection of sentinel lymphatic region with activated carbon particles in lymph node dissection for colorectal cancer.Gan To Kagaku Ryoho, 2002, 29(12): 2291-2293.
  4. 4. 　Busch FM, Sayegh ES．Roentgenographic visualization of human testicular lymphatics：a preliminary report.J Urol, 1963, 89(14)：106-110.
  5. 5. 　Cabanas RM．An approach for the treatment of penile carcinoma. Cancer, 1977, 39(2)：456-466.
  6. 6. 　Minamiya Y, Ogawa J. Benefit of sentinel lymph node mapping in non-small cell lung cancer. Ann Thorac Cardiovasc Surg, 2006, 12(6)：381-382．.
  7. 7. 　Minamiya Y, Ogawa J. The current status of sentinel lymph node mapping in non-small cell lung cancer. Ann Thorac Cardiovase Surg, 2005, 11(2)：67-72．.
  8. 8. 　Ono T, Minamiya Y, Ito M, et al. Sentinel node mapping and micrometastasis in patients with clinical stage IA non-small cell lung cancer.Interact Cardiovasc Thorac Surg, 2009, 9(4)：659-661.
  9. 9. 　李樹本, 何建行, 陳漢章, 等．納米炭在微創(chuàng)肺癌淋巴結(jié)清掃術(shù)中的應(yīng)用.中華腫瘤雜志, 2008, 30(3)：228-230．.
  10. 10. 　Liu CL, Yang TL, Chen BF. Sentinel lymph node mapping with emulsion of activated carbon particles in patients with pre-mastectomy diagnosis of intraductal carcinoma of the breast. J Chin Med Assoc, 2003, 66(7)：406-410.
  11. 11. 　鄭蘭東, 皇甫深強, 王新濤, 等. 活性炭微粒子在胃癌淋巴結(jié)清除中的應(yīng)用研究.中國現(xiàn)代普通外科進展, 2011, 14(9)：697-699.
  12. 12. 　鄧昊, 舒細記, 鎮(zhèn)鴻燕, 等．結(jié)直腸癌淋巴結(jié)微轉(zhuǎn)移對預(yù)后影響的意義．癌癥, 2003, 22(7)：762-766．.
  13. 13. 　Saha S, Wiese D, Badin J, et a1．Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging.Ann Surg Oncol, 2000, 7(2)：120-124．.
  14. 14. 　Melfi FM, Chella A, Menconi GF, et al. Intraoperative radioguided sentinel lymph node biopsy in non-small cell lung cancer. Eur J Cardiothorac Surg, 2003, 23(2)：214-220.
  15. 15. 　瞿歡, 張亞男. 納米炭在乳腺癌治療中的應(yīng)用.中國普通外科雜志, 2009, 18(5 )：495-497.
  16. 16. 　Akamo Y, Mizuno I, Takeyama H, et al. Chemotherapy targeting regional lymph nodes by gastric submucosal injection of liposomal adriamycin in patients with gastric cancer. Gan To Kagaku Ryoho, 1997, 24(12)：1712-1714.
  17. 17. 　Natsugoe S, Shimada M, Kumanohoso T, et al. Enhanced efficacy of bleomycin adsorbed on silica particles against lymph node metastasis in patients with esophageal cancer：a pilot study. Surgery, 1995, 117(6)：636-641.
  18. 18. 　Chen J，Wang L，Yao Q，et al. Drug concentrations in axillary lymph nodes after lymphatic chemotherapy on patients with breast cancer . Breast Cancer Res，2004，6(4)：R474-R477.
  19. 19. 　鮑傳慶, 許炳華, 沈曉明, 等．載藥納米炭在結(jié)腸癌手術(shù)中的應(yīng)用. 江蘇醫(yī)藥, 2007, 33(10)：1004-1005.
  20. 20. 　吳武軍, 曾健, 潘承恩．活性炭-表阿霉素混懸液對乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的治療作用．南方醫(yī)科大學(xué)學(xué)報, 2006, 26(12)：1812-1814．.
  21. 21. 　曲秋蓮, 張英鴿, 孫嵐. 納米活性炭對絲裂霉素C的吸附與緩釋性能研究.軍事醫(yī)學(xué)科學(xué)院院刊, 2004, 28(6)：552-554.
  22. 22. 　Okamoto K, Sawai K, Minato H, et al. Number and anatomical extent of lymph node metastases in gastric cancer： analysis using intra-lymph node injection of activated carbon particles (CH40). Jpn J Clin Oncol, 1999, 29(2)：74-77.
  23. 23. 　Yokota T, Saito T, Narushima Y, et al. Lymph-node staining with activated carbon CH40： a new method for axillary lymph-node dissection in breast cancer. Can J Surg, 2000, 43(3)： 191-196.
  24. 24. 　Ko K, Han BK, Jang KM, et al．The value of ultrasound-guided tattooing localization of nonpalpable breast lesions.Korean J Radiol, 2007, 8(4)：295-301．.
  25. 25. 　Tomizawa Y, Nakajima T, Kohno T, et al. Clinicopathological significance of Fhit protein expression in stage I non-small cell lung carcinoma. Cancer Res, 1998, 58(23)： 5478-5483.
  26. 26. 　高紅, 鄭春雷, 龐達. 載藥國產(chǎn)納米活性炭在胃癌根治術(shù)中的應(yīng)用.齊齊哈爾醫(yī)學(xué)院學(xué)報, 2010, 31(18)：2859-2862.