术中荧光微球免疫层析法快速识别甲状旁腺

目的 探讨荧光微球免疫层析法在甲状腺及甲状旁腺手术中快速辨识甲状旁腺的可行性。方法 收集2017年7月至10月吉林大学第一医院甲状腺外科同一医疗组进行甲状腺及甲状旁腺手术的36例病人资料。术中由同一术者使用1 mL注射器针头对手术中切除的可疑组织（甲状旁腺、脂肪、淋巴结、甲状腺）进行穿刺。使用HG-98免疫定量分析仪测出其T₁值（检测值）与C值（质控值）。比较不同组织T₁/C值的差异,并与病理结果对照。结果 共收集51组数据。甲状旁腺组织T₁/C值为(3.653±3.177),非甲状旁腺组织T₁/C值为(0.056±0.027),有统计学差异（P<0.01)。甲状旁腺与甲状腺、淋巴结、脂肪的T₁/C值之间差异有统计学意义（P<0.05）。甲状旁腺与甲状旁腺腺瘤T₁/C值无统计学差异（P>0.05）。荧光微球免疫层析法识别甲状旁腺的灵敏度（真阳性率）95.7%（22/23）,特异度（真阴性率）100%（28/28）,假阳性率（误诊率）0（0/28）,假阴性率（漏诊率）4.4%（1/23）,准确率98.0%（50/51）。结论 应用荧光微球免疫层析法可术中即时辨识甲状旁腺组织,灵敏度和特异度高,操作简单、便捷,建议临床推广。

Rapid identification of parathyroid by fluorescence microsphere immunochromatography

Objective To explore the feasibility of rapid identification of parathyroid with fluorescence microsphere immunochromatography during thyroid and parathyroid surgery. Methods Clinical data of 36 patients who underwent thyroid and parathyroid surgery by same surgical group in Department of Thyroid Surgery First Hospital of Jilin University from July 2017 to October were collected. The parathyroid and non-parathyroid tissue such as thyroid, fat tissue and lymph node which were resected were punctured by same operator using 1 mL needle. The T1 (test value) and C (control value) were measured by fluorescence microsphere immunochromatography. T1/C were compared between different tissues and T1/C of the punctured tissue compared with the pathological diagnosis. Results A total of 51 sets of data were obtained. T1/C of parathyroid was (3.653± 3.177) and T1/C of non-parathyroid tissue was (0.056± 0.027) with statistically significant diffe-rence(P< 0.01). T1/C of parathyroid was significantly higher from that of non-parathyroid tissue including thyroid, lymph node and fat tissue (P< 0.05). There was no significant difference between T1/C of parathyroid and parathyroid adenomas (P> 0.05). The results of immunofluorescence test to identify parathyroid had sensitivity (true positive rate) 95.7% (22/23), specificity (true negative rate) 100% (28/28), false positive rate (misdiagnosis rate) 0 (0/28), false negative rate (omission diagnostic rate) 4.4% (1/23) and accuracy 98.0% (50/51). Conclusions Fluorescence microsphere immunochromatography can be used to identify parathyroid in real-time mode during surgery with high sensitivity and specificity, which is a convenient procedure and valuable to be recommended.