吲哚菁绿荧光示踪标记法对甲状腺癌前哨淋巴结活检的临床价值

Clinical value of indocyanine green fluorescent labeling method in sentinel lymph node biopsy on patients with thyroid carcinoma

目的 :研究应用吲哚菁绿荧光示踪标记法对甲状腺癌前哨淋巴结活检的临床价值。方法 :选取2016年1月—2017年8月收治的甲状腺肿瘤患者198例,99例甲状腺良性肿瘤患者为对照组,99例甲状腺癌患者为观察组。组内随机分为甲、乙、丙三组,每组各33例。甲乙丙组吲哚菁绿荧光示踪剂的浓度分别为1.25 mg/mL、2.5 mg/mL和5 mg/mL,行荧光示踪前哨淋巴结活检术。比较各组的前哨淋巴结检出率和前哨淋巴结平均检出个数以及假阴性率、敏感度和准确度。结果:观察组乙组前哨淋巴结检出率明显高于甲组和丙组(P<0.05)。观察组乙组平均检出前哨淋巴结数目明显多于甲组和丙组(P<0.05)。观察组乙组的假阴性率、敏感度均明显优于甲组和丙组(P<0.05)。结论:吲哚菁绿荧光示踪标记法对甲状腺癌患者进行前哨淋巴结活检,具有检出率高、检测范围广、敏感度高的优势,对于改良手术方式具有重要的临床价值。

Objective： To study the clinical value of combined indocyanine green fluorescence labeling method in sentinel lymph node biopsy on patients with thyroid carcinoma. Methods： Patients of thyroid tumor in our hospital from January 2016 to August 2017 were selected as the research object. 99 cases of thyroid benign tumor patients were randomly selected as the control group, 99 cases of thyroid carcinoma patients were randomly selected as the observation group. According to the random number table method, patients in the group were randomly divided into A, B and C three groups, 33 cases in each group. Group A were used 1.25mg/mL indocyanine green as a fluorescent tracer, group B were used 2.5mg/mL indocyanine green as a fluorescent tracer, group C were used 5mg/mL indocyanine green as fluorescent tracer to tracer for sentinel lymph node biopsy. The detection rate of sentinel lymph node and the average number of sentinel lymph nodes of each group were compared, and the false negative rate, sensitivity and accuracy of each group were also compared. Results： The detection rate of anterior sentinel lymph node in the group B was higher than that in the group A and group C （P〈0.05）. The average number of sentinel lymph nodes in the group B was significantly higher than that in the control group A and group C（P〈0.05）. The false negative rate and sensitivity of the group B were significantly better than those of the group A and group C（P〈0.05）. Conclusi on： Indocyanine green fluorescent tracer method in sentinel lymph node biopsy has high detection rate of sentinel lymph node and detection range and high sensitivity advantage for patients with thyroid carcinoma, which has important clinical value for improving the operation methods, it is worth in clinical promotion.