Role of carbon nanoparticle suspension in sentinel lymph node biopsy for
early-stage cervical cancer: a prospective study
Abstract
Abstract 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 SLN 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% vs. 71.91%; p = 0.000). Two patients had
false-negative results, accounting for 0.615% of patients who had
successful SLN detection. SLNB with CNS had sensitivity of 92.86%,
false-negative rate (FNR) of 7.14%, 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 pathologic type or grade, stage, depth of stromal invasion,
surgical approach, menopausal status, or prior treatment with
chemotherapy (p > 0.05). Conclusions SLNB 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. Keywords SLNB, CNS,
early-stage cervical cancer