淋巴示踪剂在甲状腺乳头状癌淋巴清扫中的作用

The lymphatic tracer in lymph node dissection in papillary thyroid carcinoma

目的探讨淋巴示踪剂在甲状腺乳头状癌淋巴清扫和病理检查中的作用。方法选择甲状腺乳头状癌患者共103例,分为示踪剂组和对照组,示踪组又随机分为两个亚组,其中A组采用纳米炭为示踪剂,B组采用亚甲蓝为示踪剂,对照组不采用淋巴结示踪剂。观察各组淋巴结示踪的结果。结果 A组的起始示踪时间显著早于B组,而持续示踪时间显著长于B组。A组检获的淋巴结枚数显著高于B组和对照组,A组检获的微小淋巴结(<2 mm)比率也显著高于B组。3组淋巴结转移率无统计学差异,A组染色淋巴结出现肿瘤转移比率显著高于B组。结论纳米炭的淋巴趋向性和示踪效果均优于亚甲蓝,可增加甲状腺癌淋巴结清扫彻底性,值得推广应用。

Objective To investigate the role of lymphatic tracer in lymph node dissection in papillary thyroid carcinoma. Methods One hundred three patients with papillary thyroid cancer were collected and divided into two groups. Tracer group was randomly divided into two subgroups,using nano- carbon as tracer in group A and methylene blue as tracer in group B. Lymph node tracer was not used in the control group.The results of lymph node tracing were observed in each group. Results The initial tracer time in group A was significantly earlier than group B,and continuous tracer time in group A was significantly longer than group B. Number of lymph node seized in group A was significantly higher than group B and control group. The proportion of tiny lymph nodes（ 〈2 mm） seized in group A was also significantly higher than group B. There was no significant difference in the proportion of lymph node metastasis in 3 groups. Proportion of stained lymph node metastasis in group A appeared significantly higher than group B. Conclusion Lymphatic tropism and tracer effects of nano- carbon are superior to methylene blue,and the use of nano- carbon permits thorough lymph node dissection in thyroid cancer and is worthy of application.