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Role of carbon nanoparticle suspension in sentinel lymph node biopsy for early-stage cervical cancer: a prospective study
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  • Ya Xie,
  • Qian Wang,
  • Huiqing Li,
  • Haixiao Wen,
  • Weiwei Zhang,
  • Jing Bai,
  • Lei Cai,
  • Jianping Yang,
  • Shuping Yan,
  • Jiaya Mo,
  • Dong Wang,
  • Ruixia Guo
Ya Xie
Zhengzhou University First Affiliated Hospital
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Qian Wang
Zhengzhou University First Affiliated Hospital
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Huiqing Li
Zhengzhou University First Affiliated Hospital
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Haixiao Wen
Zhengzhou University First Affiliated Hospital
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Weiwei Zhang
Zhengzhou University First Affiliated Hospital
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Jing Bai
Zhengzhou University First Affiliated Hospital
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Lei Cai
Zhengzhou University First Affiliated Hospital
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Jianping Yang
Zhengzhou University First Affiliated Hospital
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Shuping Yan
Zhengzhou University First Affiliated Hospital
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Jiaya Mo
Zhengzhou University First Affiliated Hospital
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Dong Wang
Zhengzhou University First Affiliated Hospital
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Ruixia Guo
Zhengzhou University First Affiliated Hospital
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Peer review status:UNDER REVIEW

11 Mar 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
12 Mar 2020Submission Checks Completed
12 Mar 2020Assigned to Editor
24 Mar 2020Reviewer(s) Assigned
29 Apr 2020Review(s) Completed, Editorial Evaluation Pending
13 May 2020Editorial Decision: Revise Major
17 Jul 20201st Revision Received
31 Jul 2020Submission Checks Completed
31 Jul 2020Assigned to Editor
10 Aug 2020Reviewer(s) Assigned

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