纳米碳对甲状腺乳头状癌术后短期疗效的影响

Impact of using carbon nanoparticle for postoperative short-term efficacy of papillary thyroid carcinoma

目的探讨纳米碳在甲状腺乳头状癌术中的应用,对中央区淋巴结清扫效果、术后短期血清甲状腺球蛋白的影响。方法回顾性分析2017年11月至2018年9月行全甲状腺切除+中央区淋巴结清扫术的112例患者,根据术中是否使用纳米碳分为纳米碳组(57例)和对照组(55例),对比分析两组检出淋巴结数量、转移情况及术后血清甲状腺球蛋白(Tg)。结果纳米碳组和对照组检出中央区淋巴结的总数分别为568枚和504枚,无统计学差异(P=0.508);转移淋巴结数分别为240枚和222枚,无统计学差异(P=0.965)。纳米碳组中黑染的淋巴结转移率(21.2%)明显低于未被染色的淋巴结(59.1%),有统计学差异(P=0.000)。纳米碳组和对照组术后1个月平均Tg值中位数分别为0.43 ng/mL和0.19 ng/mL,无统计学差异(P=0.401)。结论尚不能认为术中使用纳米碳可以显著增加中央区淋巴结检出数量,未被染色的淋巴结恶性概率比黑染的淋巴结大,纳米碳对甲状腺乳头状癌术后短期肿瘤指标尚无改善作用。

Objective To explore the application of carbon nanoparticle(CNP)during total thyroidectomy for papillary carcinoma,especially for central neck dissection and postoperative serum thyroglobulin(Tg).Methods 112 patients were recruited retrospectively among those who performed total thyroidectomy and central neck dissection from November 2017 to September 2018.57 of them receiving injection of CNP intraoperatively were defined as CNP group while others were control group.Number of lymph nodes(LNs)resected,rate of metastasis and postoperative Tg were compared between two groups.Results Amount of central LNs detected from CNP group and control group were 568 and 504 respectively.No significance could be discovered between them(P=0.508).Neither did significance between LNs involved of two groups,which was 240 and 222 respectively(P=0.965).However,metastatic rate of black-dyed LNs was significantly lower than that of undyed(21.2%vs 59.1%,P=0.000).In terms of postoperative Tg level,there was no significance between two groups(0.43 ng/mL vs 0.19 ng/mL,P=0.401).Conclusion The present study did not show that the use of carbon nanoparticles significantly increased the number of lymph nodes resection in the central region.The metastatic rate of black-dyed LNs is lower than that of undyed.CNP would not be benefit for improvement of postoperative short-term oncologic outcomes among patients with papillary thyroid carcinoma.