纳米碳示踪剂在甲状腺癌根治术中的应用

目的:探讨纳米碳示踪剂在甲状腺癌根治术中的应用价值。方法:将2013年1月—2014年5月收治的80例甲状腺癌患者随机均分为试验组与对照组,试验组术中甲状腺内注入纳米碳混悬液后按黑染淋巴结的范围清扫患侧VI区淋巴结,对照组常规清扫患侧VI区淋巴结。比较两组淋巴结清扫数、癌转移淋巴结数及术后甲状旁腺损伤发生率。结果:试验组共清扫461枚,其中黑染淋巴结441枚,对照组共清扫淋巴结272枚;试验组中发现癌转移淋巴结数量为197枚,而对照组中为106枚,以上指标两组间差异均有统计学意义(均P0.05)。试验组与对照组癌细胞淋巴结转移率无明显差异(42.73%vs.38.97%,P0.05)。试验组术后病理未找到甲状旁腺组织,也未出现低钙血症,而对照组有5例找到甲状旁腺组织,同时5例出现低钙血症,但两组间差异未达统计学意义(P=0.055)。结论:纳米碳在甲状腺癌根治术中能够使VI区淋巴结得到很好的显影,利于淋巴结彻底清扫,同时碳不会黑染甲状旁腺,可以避免甲状旁腺的误切。

Application of carbon nanoparticle tracer in radical neck dissection for thyroid cancer

Objective: To investigate the application value of carbon nanoparticle tracer in radical neck dissection for thyroid cancer. Methods: Eighty patients with thyroid cancer admitted during January 2013 to May 2014 were equally randomized into study group and control group. Patients in study group underwent ipsilateral level VI lymph node dissection according to scope of black-stained lymph nodes after the intrathyroid injection of carbon nanoparticles during operation, while those in control group underwent routine ipsilateral level VI lymph node dissection. The number of dissected lymph nodes and metastatic lymph nodes as well as the incidence of parathyroid injury between the two groups were compared. Results: The total number of dissected lymph nodes was 461 (441 black-stained lymph nodes) in study group, and was 272 in control group; the number of lymph nodes with tumor metastasis was 197 in study group, and 106 in control group, and both above parameters had statistical difference between the two groups (both P<0.05). There was no significant difference between study group and control group in lymphatic metastasis rate (42.73% vs. 38.97%, P>0.05). No parathyroid tissue was found in pathological examination and no postoperative hypocalcemia occurred in study group, while parathyroid tissue was found in 5 cases and postoperative hypocalcemia occurred in 5 cases in control group, however, the incidence of parathyroid injury did not reach statistical significance (P=0.055). Conclusion: Using carbon nanoparticles in radical neck dissection for thyroid cancer can clearly show the level VI lymph nodes, and thereby help in complete lymph node dissection, and meanwhile, it does not stain the parathyroid tissue, so it can avoid the inadvertent dissection of the parathyroid glands.