Application of Carbon Nanoparticles in Neck Dissection of Clinically Node-Negative Papillary Thyroid Carcinoma.
Application of Carbon Nanoparticles in Neck Dissection of Clinically Node-Negative Papillary Thyroid Carcinoma.
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DOI：
10.1155/2021/6693585
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发表时间：
2021
影响因子：
--
通讯作者：
Feng Y
中科院分区：
文献类型：
--
作者：
Chen Z;Zhong Z;Chen G;Feng Y
本研究旨在评价碳纳米颗粒在颈淋巴清扫术中的优势，并总结其在临床结节阴性的甲状腺乳头状癌(CN0PTC)治疗中的应用。作为一项回顾性队列研究，我们将入选的患者按使用情况分为两组，碳纳米粒(CN)组和对照组。CN组用CN显露引流淋巴结，取下的淋巴结进行快速冰冻试验。如有转移，则行改良根治性侧向淋巴清扫术。两组患者均常规行预防性中央淋巴结清扫术。最后，收集人口学资料、肿瘤特征、术后病理结果和实验室资料进行分析。本研究共入选CN0PTC患者61例，CN组33例，对照组28例。CN黑染率为29/40(72.5%)，阳性预测率为34.5%。侧颈主要黑染区域为III级，淋巴结转移率最高(17.5%)。CN组和对照组VI级转移率分别为30%和11.8%(P=0.058)。在可获得的随访期间，无一例复发。统计分析表明，CN混悬液可显著降低甲状旁腺受损的风险(低钙血症P=0.001；甲状旁腺功能减退症P=0.047)。临床分期为cT1aN0的甲状腺微小乳头状癌患者的侧颈转移并不少见。CN可以帮助外科医生区分真正需要LLND的人。在预防性CLND中，CN充当示踪剂，使甲状旁腺更容易识别，并避免神经和腺体受到伤害的风险。
The purpose of this retrospective study was to evaluate the advantages of carbon nanoparticles in neck dissection and to conclude its application in the treatment of clinically node-negative papillary thyroid carcinoma (CN0PTC). As a retrospective cohort study, we divided the enrolled patients into two groups, the carbon nanoparticle (CN) group and the control group according to the usage of CN. In the CN group, CN was applied to reveal drainage lymph nodes and the picked LNs were sent for fast frozen testing. If metastasis exits, modified radical lateral lymph node dissection (LLND) was performed. For both groups, prophylactic central lymph node dissection was routinely done. Finally, the demographic information, tumor characteristics, postoperative pathological results, and laboratory data were collected for analysis. A total of 61 CN0PTC were enrolled in this study, 33 in the CN group and 28 in the control group. The black-stained rate for CN was 29/40 (72.5%) with a positive prediction rate of 34.5%. The mainly black-stained region in the lateral neck was level III and possesses the highest lymph node ratio (17.5%). The metastasis that occurred in level VI was 30% and 11.8% in the CN and control groups, respectively (p = 0.058). During the available follow-up, no one showed recurrence. Statistical analysis showed that the CN suspension can significantly reduce the risk of damage to the parathyroid gland (p = 0.001 for hypocalcemia, <0.05; p = 0.047 for hypoparathyroidism, <0.05). The lateral neck metastasis in patients with papillary thyroid microcarcinoma in clinical stage cT1aN0 is not rare. CN can help surgeons to distinguish the real person who actually needs LLND. In prophylactic CLND, CN acts as a tracer which makes the parathyroid gland more identifiable and avoids risks of injuries to nerves and glands.
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