Zhang S, Jiang X H
Department of Head and Neck Surgery, Hubei Cancer Hospital, Wuhan, 430079, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Apr;32(8):606-609. doi: 10.13201/j.issn.1001-1781.2018.08.012.
To investigate the clinical characteristics of the risk factors of papillary thyroid carcinoma in different ages of young patients (<45y)associated with carbon nanoparticles.A retrospective statistics and analysis of 183 patients who were diagnosed and treated; carbon nanoparticles were injected into the thyroid during operation and at last the conventional pathological diagnosis were papillary thyroid carcinoma of all patients; to analysis the gender, tumor size, capsular invasion, lymph node metastasis, multifocality and other risk factors between the <25y and 25-<5y patients.The parathyroid were better identified, while the central lymph nodes better turned black after carbon nanoparticles injected; <25y compared to 25-<45y in the tumor size, multifocality, capsular invasion, extrathyroidal extension, associated with Hashimoto Thyroiditis, the differences had statistical significant(<0.01 or <0.05).In young (<45y) thyroid papillary carcinoma, preoperative serum thyroglobulin level was beyond the normal range, indicating a large possibility of lateral neck lymph node metastasized, but the two age groups had no statistical significant(>0.05) in serum thyroglobulin and thyroid stimulating hormone.Carbon nanoparticles can effectively recognize parathyroid and trace central lymph nodes. In the <25y groups, the tumor diameter is more likely to exceed 1cm, the lateral neck nodes are more easily metastasized, capsular invasion and extrathyroidal extension are also more easily to turn up. While the 25-<45y groups are more likely to form multifocality, which may be accompanied by Hashimoto Thyroiditis and prone to occur central lymph nodes metastasized. In the younger patients (<45y), the more preoperative serum thyroglobulin higher, the more probable lateral neck nodes metastasized.
探讨不同年龄（<45岁）青年甲状腺乳头状癌患者与碳纳米颗粒相关危险因素的临床特征。回顾性统计分析183例确诊并接受治疗的患者；术中向甲状腺注射碳纳米颗粒，最终所有患者经常规病理诊断为甲状腺乳头状癌；分析<25岁与25-<45岁患者之间的性别、肿瘤大小、包膜侵犯、淋巴结转移、多灶性等危险因素。注射碳纳米颗粒后甲状旁腺辨识度更高，中央淋巴结更易变黑；<25岁组与25-<45岁组在肿瘤大小、多灶性、包膜侵犯、甲状腺外侵犯、合并桥本甲状腺炎方面差异有统计学意义（<0.01或<0.05）。青年（<45岁）甲状腺乳头状癌患者术前血清甲状腺球蛋白水平超出正常范围，提示侧颈淋巴结转移可能性大，但两组血清甲状腺球蛋白和促甲状腺激素比较差异无统计学意义（>0.05）。碳纳米颗粒能有效识别甲状旁腺并追踪中央淋巴结。<25岁组肿瘤直径更易超过1cm，侧颈淋巴结更易转移，包膜侵犯和甲状腺外侵犯也更易出现。而25-<45岁组更易形成多灶性，可能合并桥本甲状腺炎且易发生中央淋巴结转移。在年龄较小（<45岁）的患者中，术前血清甲状腺球蛋白越高，侧颈淋巴结转移的可能性越大。
