切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2014, Vol. 08 ›› Issue (06) : 451 -455. doi: 10.3877/cma.j.issn.1674-0793.2014.06.008

所属专题: 文献

论著

纳米碳混悬液在甲状腺乳头状癌术中应用的研究
邓维叶1, 李浩1, 陈艳峰1, 刘万里2, 李安华3, 李秋梨1, 黄海燕1, 王建伟3, 林少建1, 高云飞1, 郭朱明1,()   
  1. 1. 510060 广州,华南肿瘤学国家重点实验室 肿瘤医学协同创新中心 中山大学肿瘤防治中心头颈科
    2. 510060 广州,华南肿瘤学国家重点实验室 肿瘤医学协同创新中心 中山大学肿瘤防治中心检验科
    3. 510060 广州,华南肿瘤学国家重点实验室 肿瘤医学协同创新中心 中山大学肿瘤防治中心超声心电科
  • 收稿日期:2014-01-14 出版日期:2014-12-01
  • 通信作者: 郭朱明
  • 基金资助:
    广东省科技计划项目(2012B031800292)

Clinical application of carbon nanoparticles suspension in papillary thyroid carcinoma

Weiye Deng1, Hao Li1, Yanfeng Chen1, Wanli Liu2, Anhua Li3, Qiuli Li1, Haiyan Huang1, Jianwei Wang3, Shaojian Lin1, Yunfei Gao1, Zhuming Guo1,()   

  1. 1. Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China
  • Received:2014-01-14 Published:2014-12-01
  • Corresponding author: Zhuming Guo
  • About author:
    Corresponding author: Guo Zhuming, Email:
引用本文:

邓维叶, 李浩, 陈艳峰, 刘万里, 李安华, 李秋梨, 黄海燕, 王建伟, 林少建, 高云飞, 郭朱明. 纳米碳混悬液在甲状腺乳头状癌术中应用的研究[J/OL]. 中华普通外科学文献(电子版), 2014, 08(06): 451-455.

Weiye Deng, Hao Li, Yanfeng Chen, Wanli Liu, Anhua Li, Qiuli Li, Haiyan Huang, Jianwei Wang, Shaojian Lin, Yunfei Gao, Zhuming Guo. Clinical application of carbon nanoparticles suspension in papillary thyroid carcinoma[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(06): 451-455.

目的

探讨纳米碳混悬液注射对总淋巴结、转移淋巴结的检出情况及对甲状旁腺负显染作用的影响。

方法

回顾性分析284例甲状腺乳头状癌患者的临床及病理资料,其中70例为纳米碳混悬液注射组(试验组),214例为常规手术组(对照组)。所有标本常规进行病理检查。

结果

试验组和对照组总淋巴结检出数分别为1 841、2 828枚;试验组总淋巴结检出率优于对照组(Z=-4.112,P<0.01)。总转移淋巴结检出数分别为481、754枚;总转移淋巴结检出率试验组优于对照组(Z=-2.457,P=0.014)。试验组Ⅵ区检出的淋巴结及转移淋巴结数检出率优于对照组(Z=-3.819,P<0.01)。试验组中央区清扫组织中检出甲状旁腺比例为25.7%,低于对照组39.7%(Z=-2.521,P=0.012)。

结论

纳米碳混悬液可被用作示踪剂增加甲状腺癌手术的总淋巴结检出数目,同时是一种创伤小的可保护甲状旁腺的有效方法。

Objective

To study the detected number of overall and metastatic lymph nodes and the negatively-stained parathyroid glands with the carbon nanoparticles injection.

Methods

This retrospective analysis included the clinical and pathological data of 284 patients. Among them, 70 were injected with carbon nanoparticles suspension (the trial group), the other 214 patients undergoing conventional surgery (the control group). Routine pathological examination was adopted in all resected specimens.

Results

The total number of detected lymph nodes was 1 841 and 2 828 in the two groups, respectively. The lymph nodes detection rate of the trial group was superior to that of the control group (Z=-4.112, P<0.01) .There were 481 and 754 metastatic lymph nodes detected in the trial group and control group; the detection rate of the trial group was superior to that of the control group (Z=-2.457, P=0.014). The lymph nodes and metastatic lymph nodes of level VI detection rate of the trial group were superior to those of the control group (Z=-3.819, P<0.01). Pathologic results of the specimens showed that parathyroid glands tissues were less found in the trial group than the control group, 25.7% and 39.7% respectively(Z=-2.521, P=0.012) .

Conclusion

Carbon nanoparticles suspension can increase the detection of overall lymph nodes in thyroid operations and it is an economic, less traumatic approach to protect the parathyroid glands.

表1 两组患者的一般临床病理资料(例,χ2检验)
表2 两组患者的淋巴结检出数[M(X25,X75a]
[1]
Tuttle RM,Leboeuf R. Follow up approaches in thyroid cancer: a risk adapted paradigm[J]. Endocrinol Metab Clin North Am, 2008, 37(2): 419-435, ix-x.
[2]
Mazzaferri EL,Kloos RT. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer[J]. J Clin Endocrinol Metab, 2001, 86(4): 1447-1463.
[3]
Di Fabio F,Casella C,Bugari G, et al. Identification of patients at low risk for thyroidectomy-related hypocalcemia by intraoperative quick PTH[J]. World J Surg, 2006, 30(8): 1428-1433.
[4]
Sorgato N,Pennelli G,Boschin IM, et al. Can we avoid inadvertent parathyroidectomy during thyroid surgery?[J]. In Vivo, 2009, 23(3): 433-439.
[5]
Hao RT,Chen J,Zhao LH, et al. Sentinel lymph node biopsy using carbon nanoparticles for Chinese patients with papillary thyroid microcarcinoma[J]. Eur J Surg Oncol, 2012, 38(8): 718-724.
[6]
Liu CL,Yang TL,Chen BF. Sentinel lymph node mapping with emulsion of activated carbon particles in patients with pre-mastectomy diagnosis of intraductal carcinoma of the breast[J]. J Chin Med Assoc, 2003, 66(7): 406-410.
[7]
Giuliano AE,Hunt KK,Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial[J]. JAMA, 2011, 305(6): 569-575.
[8]
Veronesi U,Viale G,Paganelli G, et al. Sentinel lymph node biopsy in breast cancer: ten-year results of a randomized controlled study[J]. Ann Surg, 2010, 251(4): 595-600.
[9]
Catarci M,Guadagni S,Zaraca F, et al. Prospective randomized evaluation of preoperative endoscopic vital staining using CH-40 for lymph node dissection in gastric cancer[J]. Ann Surg Oncol, 1998, 5(7): 580-584.
[10]
Cai HK,He HF,Tian W, et al. Colorectal cancer lymph node staining by activated carbon nanoparticles suspension in vivo or methylene blue in vitro[J]. World J Gastroenterol, 2012, 18(42):6148-6154.
[11]
He J,Li S,Shao W, et al. Activated carbon nanoparticles or methylene blue as tracer during video-assisted thoracic surgery for lung cancer can help pathologist find the detected lymph nodes[J]. J Surg Oncol, 2010, 102(6): 676-682.
[12]
Yang Q,Wang XD,Chen J, et al. A clinical study on regional lymphatic chemotherapy using an activated carbon nanoparticle-epirubicin in patients with breast cancer[J]. Tumour Biol, 2012, 33(6): 2341-2348.
[13]
Hagiwara A,Takahashi T,Sawai K, et al. Lymph nodal vital staining with newer carbon particle suspensions compared with India ink: experimental and clinical observations[J]. Lymphology, 1992, 25(2): 84-89.
[14]
Asin L,Ibarra MR,Tres A, et al. Controlled cell death by magnetic hyperthermia: effects of exposure time, field amplitude, and nanoparticle concentration[J]. Pharm Res, 2012, 29(5): 1319-1327.
[15]
Madru R,Kjellman P,Olsson F, et al. 99mTc-labeled superpara-magnetic iron oxide nanoparticles for multimodality SPECT/MRI of sentinel lymph nodes[J]. J Nucl Med, 2012, 53(3): 459-463.
[16]
Hay ID,Thompson GB,Grant CS, et al. Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940-1999): temporal trends in initial therapy and long-term outcome in 2 444 consecutively treated patients[J]. World J Surg, 2002, 26(8): 879-885.
[17]
Vassiliou I,Tympa A,Arkadopoulos N, et al. Total thyroidectomy as the single surgical option for benign and malignant thyroid disease: a surgical challenge[J]. Arch Med Sci, 2013, 9(1): 74-78.
[18]
Chao TC,Jeng LB,Lin JD, et al. Reoperative thyroid surgery[J]. World J Surg, 1997, 21(6): 644-647.
[19]
Guerrero MA,Suh I,Vriens MR, et al. The number of needle passes affects the accuracy of parathyroid hormone assay with intraoperative parathyroid aspiration[J]. Am J Surg, 2010, 200(6): 701-705.
[1] 蔡林利, 宋宏萍, 巨艳, 党晓智, 韩铭, 肖迎聪. 超声结合临床病理指标模型对T1-2期乳腺癌腋窝淋巴结转移的预测价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(02): 143-150.
[2] 孙帼, 谢迎东, 徐超丽, 杨斌. 超声联合临床特征的列线图模型预测甲状腺乳头状癌淋巴结转移的价值[J/OL]. 中华医学超声杂志(电子版), 2023, 20(07): 734-742.
[3] 周世振, 朱兴亚, 袁庆港, 刘理想, 王凯, 缪骥, 丁超, 汪灏, 管文贤. 吲哚菁绿荧光成像技术在腹腔镜直肠癌侧方淋巴结清扫中的应用效果分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 44-47.
[4] 黄一博, 李至彦, 林晨, 陶亮, 王萌, 管文贤. 胃癌根治术中淋巴结示踪剂的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 586-588.
[5] 韩婧, 郝少龙, 康骅. 北京市单中心甲状腺癌患者临床特征的回顾分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 490-493.
[6] 徐成, 王璐璐, 王少华. 洗脱液甲状腺球蛋白在甲状腺乳头状癌转移淋巴结中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 701-704.
[7] 陆镜明, 韩大为, 任耀星, 黄天笑, 向俊西, 张谞丰, 吕毅, 王傅民. 基于术前影像组学的肝内胆管细胞癌淋巴结转移预测的系统性分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 852-858.
[8] 张伟伟, 陈启, 翁和语, 黄亮. 随机森林模型预测T1 期结直肠癌淋巴结转移的初步研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 389-393.
[9] 苑乐添, 王艺霖, 沈子剑, 闫呈新. 血清GDF15、sB7-H1联合多层螺旋CT灌注成像技术对胃癌患者淋巴结转移的诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(01): 62-66.
[10] 王曦娅, 尹弘青, 丁伟, 徐滨, 于海源, 马东升, 邵军. 桥本背景下甲状腺乳头状癌多参数分析预测大容量淋巴结转移[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 548-554.
[11] 卫星彤, 李昊昌, 赵欣. 甲状腺木乃伊结节于多模态超声下的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(04): 415-419.
[12] 牟鳄贤, 李卓璇, 董浩, 于淼, 纪娟, 徐佳, 王浩, 刘世伟. 初始腋窝淋巴结转移乳腺癌新辅助治疗后腋窝病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2023, 17(10): 1027-1032.
[13] 杜倩, 张曼, 李丽, 马晓丽. 细胞蜡块技术在甲状腺细针穿刺病理诊断中的价值研究[J/OL]. 中华临床医师杂志(电子版), 2023, 17(10): 1071-1074.
[14] 胡惠英, 高劲松. 妊娠合并甲状旁腺功能减退症的诊治[J/OL]. 中华产科急救电子杂志, 2024, 13(01): 13-17.
[15] 姜超, 夏旭东, 王功夏, 何向宇, 王海彬, 李媛. 磁共振DWI及其ADC对乳腺导管原位癌伴微浸润腋窝淋巴结转移的诊断价值[J/OL]. 中华介入放射学电子杂志, 2024, 12(03): 234-243.
阅读次数
全文


摘要