纳米碳示踪前哨淋巴结在cN0甲状腺乳头状癌中的应用

Application of nano carbon tracer in sentinel lymph nodes of cN0 thyroid papillary carcinoma

目的探讨纳米碳示踪cN0甲状腺乳头状癌前哨淋巴结的可行性及有效性,并进一步探讨前哨淋巴结活检在甲状腺癌中的应用价值。方法应用纳米碳对24例甲状腺乳头状癌患者行前哨淋巴结定位活检,并常规行患侧功能性颈淋巴结清扫术,将前哨淋巴结及清扫的颈淋巴结分别送病理检查,分析前哨淋巴结分布区域及甲状腺癌淋巴转移特点。结果 24例甲状腺乳头状癌患者中,有22例显示了前哨淋巴结,平均每例1.86枚,15例为阳性,其检出率为91.67%（22/24）、灵敏度为86.67%（13/15）;准确度为54.17%~83.33%（13/24~20/24）,前哨淋巴结检出率在VI区最高77.27%（17/22）。结论纳米碳作为一种新型的淋巴示踪剂,能准确地反映颈部淋巴结的状况,对甲状腺乳头状癌淋巴结转移的判断有较高的参考价值。

[ Objective ] To study the feasibility and effective of nano carbon tracer in sentinel lymph nodes of cN0 thyroid papillary carcinoma, and to further explore the value of sentinel lymph node biopsy in thyroid carcino- ma. [Methods] 24 cases of thyroid papillary carcinoma patients underwent sentinel lymph node biopsy with nano carbon, and ipsilateral functional neck dissection were performed simultaneously. The sentinel lymph node and the dissected cervical lymph nodes were sent for pathology examine respectively. The distribution of sentinel lymph node and lymph metastasis of thyroid cancer was analyzed. [ Results ] In 24 cases of thyroid papillary cancer pa- tients, the sentinel lymph node was showed in 22 cases, 1.86 in average of every cases. 15 cases were positive, the positive rate was 91.67% （22/24）, the sensitivity was 86.67% （13/15）. The accuracy was 54.17% to 83.33% （13/24- 20/24）. The detection rate of sentinel lymph node was the highest in region VI, reached to 77.27%（17/22）. [Con- clusion] As a new lymphatic tracer, nano carbon could reflect the neck lymph node status accurately, and have great reference value on the judgment of lymph node metastasis in papillary thyroid carcinoma patents.