The potential role of carbon nanoparticles-assisted biopsy for sentinel lymph nodes of incidental thyroid carcinoma
The potential role of carbon nanoparticles-assisted biopsy for sentinel lymph nodes of incidental thyroid carcinoma
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DOI：
10.21037/gs.2019.07.08
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发表时间：
2019-08-01
期刊：
影响因子：
1.8
通讯作者：
Xiao, Qiang
中科院分区：
文献类型：
--
作者：
Zhang, Chaojie;Li, Xinyiug;Xiao, Qiang
背景：一些甲状腺癌是在良性病变甲状腺切除术后发现的，这意味着需要额外的手术和治疗。本研究旨在探讨术中前哨淋巴结活检（SLNB）在偶发性甲状腺癌诊断中的作用。方法：这是对2012年2月至2014年2月在湖南省人民医院接受甲状腺手术的541例连续患者的回顾性研究。所有患者术前及术中均诊断为甲状腺良性病变。其中，375例成功接受了纳米碳（CNs）术中前哨淋巴结活检。结果：术前诊断为结节性甲状腺肿（n=472）、伴结节的I型石本氏病（n=24）、伴结节的甲状腺功能亢进症（n=16）、伴阻塞性症状的甲状腺囊肿（n=29）。 SLNB组中，21/392例（5.4%）确诊甲状腺微小癌SIN转移。这21名患者在初次手术时接受了甲状腺癌根治性手术治疗。在无 SLNB 组（n=149）中，7 名患者（4.7%）最终被诊断为甲状腺微小癌。 6例患者不得不接受第二次手术。结论：术中SLNB有助于诊断术前和术中可能漏诊的分化型甲状腺微小癌。这可以避免进行第二次手术，因为术中前哨淋巴结冰冻切片检查可以发现甲状腺癌的转移。
Background: Some thyroid cancers are found after thyroidectomy for benign lesions, implying additional surgery and treatments. This work aimed to investigate the role of intraoperative sentinel lymph node biopsy (SLNB) for diagnosis of incidental thyroid carcinoma.Methods: This was a retrospective study of 541 consecutive patients who underwent thyroid surgery between 02/2012 and 02/2014 at the Hunan Provincial People's Hospital. All patients were diagnosed with thyroid benign lesions preoperatively and intraoperatively. Among them, 375 underwent successful intraoperative SLNB using carbon nanoparticles (CNs).Results: The preoperative diagnoses were nodular goiter (n=472), I Iashimoto's disease with nodules (n=24), hyperthyroidism with nodules (n=16), and thyroid cysts with obstructive symptoms (n=29). In the SLNB group, SIN metastasis of thyroid microcarcinoma was confirmed in 21/392 cases (5.4%). These 21 patients received radical surgical treatment for thyroid carcinoma during the initial operation. In the no-SLNB group n=149), seven patients (4.7%) were finally diagnosed with thyroid microcarcinoma. Six patients had to undergo a second surgery.Conclusions: Intraoperative SLNB could help diagnose differentiated thyroid microcarcinoma that may be missed preoperatively and intraoperatively. This could prevent the need for a second surgery since the intraoperative frozen section examination of the SLNs can reveal metastasis from thyroid cancer.