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纳米碳与亚甲蓝对甲状腺乳头状癌患者前哨淋巴结的识别

Recognition of sentinel lymph nodes in patients with papillary thyroid cancer by nano-carbon and methylene blue.

作者信息

Liu Fangzhou, Zhu Yan, Qian Yichuan, Zhang Jia, Zhang Yu, Zhang Yuan

机构信息

Fangzhou Liu, Department of Head and Neck Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing 210009, P. R. China.

Yan Zhu, Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China.

出版信息

Pak J Med Sci. 2017 Nov-Dec;33(6):1485-1489. doi: 10.12669/pjms.336.13940.

Abstract

OBJECTIVE

To compare the accuracy and feasibility of methylene blue and nano-carbon in clinical tracing of sentinel lymph nodes (SLNs) in patients with papillary thyroid cancer (PTC).

METHODS

Ninety-six PTC patients were selected and randomly divided into a methylene blue group and a nano-carbon group (n=48). During surgery, tracer agent was injected around the tumor, and SLNs were resected and subjected to frozen pathological examination. The results were compared with those of routine pathological examination after surgery.

RESULTS

Latent lymph node metastasis (level VI and lateral neck) was detected in both groups, with neck distribution of SLNs. There was no significant difference in the detection rate or accuracy of SLNs between two groups (P>0.05). The incorrect resection rate of parathyroid gland and incidence of temporary hypoparathyroidism in the methylene blue group were significantly higher than those of the nano-carbon group (t=4.137, P<0.05).

CONCLUSIONS

The state of PTC lymph nodes can be well evaluated by SLN biopsy using both methylene blue and nano-carbon as tracers, but using nano-carbon has a lower incidence rate of parathyroid injury, with great clinical prospects accordingly.

摘要

目的

比较亚甲蓝和纳米碳在甲状腺乳头状癌(PTC)患者前哨淋巴结(SLN)临床示踪中的准确性和可行性。

方法

选取96例PTC患者,随机分为亚甲蓝组和纳米碳组(n = 48)。手术中,在肿瘤周围注射示踪剂,切除SLN并进行冰冻病理检查。将结果与术后常规病理检查结果进行比较。

结果

两组均检测到隐匿性淋巴结转移(Ⅵ区和侧颈部),SLN呈颈部分布。两组SLN的检出率和准确率差异无统计学意义(P > 0.05)。亚甲蓝组甲状旁腺误切率和暂时性甲状旁腺功能减退发生率显著高于纳米碳组(t = 4.137,P < 0.05)。

结论

以亚甲蓝和纳米碳作为示踪剂进行SLN活检均可较好地评估PTC淋巴结状态,但使用纳米碳甲状旁腺损伤发生率较低,具有较大的临床应用前景。

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