Use of a Carbon Nanoparticle Tracer to Detect Sentinel Lymph Nodes for the Precise Treatment of Endometrial Carcinoma

Abstract

We evaluated the usefulness of a carbon nanoparticle (CNP) tracer for the detection of sentinel lymph nodes (SLNs) for the precise treatment of endometrial carcinoma (EC). Among patients who presented at First Affiliated Hospital, College of Medicine, Zhejiang University, and Xiangshan First People’s Hospital Medical and Health Group between February 2019 and February 2022, we selected 90 patients who required surgical treatment for EC. During the operation, CNP was injected into the cervix by the two-point method, and black-stained LNs were identified as SLNs and resected. Then, statistical analyses were conducted to evaluate SLN occurrence area, CNP traceability, SLN detection rate, as well as diagnostic data such as false negative rate (FNR), sensitivity (SEN), specificity (SPE), positive/negative predictive value (PPV/NPV), and accuracy (ACC). CNP tracing detected SLN mainly at the external iliac (45.09%) and obturator (36.36%) regions. CNP tracing of SLNs was successful in 80 patients, with an SLN detection rate of 88.89%. Eight cases (10.00%) were positive for SLNs, with an FNR of 12.50%. The SEN, SPE, PPV, NPV, and ACC values for CNP detection of SLNs were 87.50%, 98.78%, 87.50%, 98.78%, and 97.78%, respectively. Our results indicate that CNP is an effective tracer for SLNs. When operating on EC patients, CNP tracing of SLNs can help to judge lymph node metastasis and regional distribution, providing a reliable basis for the determination of surgical scope.