Efficacy and safety of methylene blue,nano-carbon,and indocyanine green in sentinel lymph node identification for cervical cancer
- VernacularTitle:亚甲蓝、纳米炭与吲哚菁绿在宫颈癌前哨淋巴结识别中的疗效与安全性
- Author:
Yu GAO
1
;
Yipin CAI
;
Jie ZHANG
;
Haiwei HUANG
Author Information
- Keywords: cervical cancer; sentinel lymph node; nano-carbon; indocyanine green; methyl-ene blue; fluorescence imaging; randomized controlled trial; minimally invasive surgery
- From: Journal of Clinical Medicine in Practice 2025;29(15):40-46
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the guiding value and safety of three tracers in identifying sentinel lymph nodes(SLN)for lymph node dissection during radical surgery for early-stage cervical cancer.Methods A total of 114 patients with early-stage cervical cancer from January 2021 to No-vember 2022 were selected as the study subjects.They were randomly divided into methylene blue group,nano-carbon group,and indocyanine green(ICG)group according to the random number ta-ble method,with 38 cases in each group.All three groups underwent radical surgery.The methylene blue group used methylene blue for SLN identification during surgery,the nano-carbon group used nano-carbon,and the ICG group used ICG fluorescence imaging.The SLN identification status and surgery-related indicators were compared among the three groups.Trauma indicators[serum cortisol(Cor),epinephrine(E),adrenocorticotropic hormone(ACTH),and C-reactive protein(CRP)]were compared among the three groups before surgery and on 1,3,and 7 d after surgery.Tumor markers[carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 125(CA125),and carbohydrate antigen 199(CA199)]were compared among the three groups before surgery and 3 months after surgery.The complication rates and recurrence rates were also compared among the three groups.Results The tracing time in the ICG group was shorter than that in the nano-carbon and methylene blue groups,and the tracing time in the nano-carbon group was shorter than that in the methylene blue group(P＜0.05).In terms of the success rate and number of identified SLN,the nano-carbon group was higher than the ICG and methylene blue groups,and the ICG group was higher than the methylene blue group(P＜0.05).Regarding the SLN resection time,the nano-car-bon group had the shortest time,and the methylene blue group had the longest time,with a statisti-cally significant difference(P＜0.05).The serum levels of CEA,AFP,CA125,and CA199 in the three groups decreased significantly 3 months after surgery compared with those before surgery(P＜0.05).The within-group effects of one-way repeated-measures analysis of variance showed that the serum levels of Cor,E,ACTH,and CRP in the three groups increased first and then decreased on 1,3,and 7 d,with statistically significant differences(P＜0.05).There was no statistically signif-icant difference in the complication rates among the three groups(P＞0.05).During the 1-year fol-low-up,2 patients were lost during follow-up in the nano-carbon group,1 in the ICG group,and 2 in the methylene blue group.No recurrence was found in any of the three groups.Conclusion Among the three tracers,ICG has the shortest time for tracing SLN during radical surgery for early-stage cer-vical cancer.Nano-carbon exhibits relatively high application value compared with the other two tracers,and it guides the scope of lymph node dissection and demonstrates certain safety.
