基于探针式甲状旁腺近红外自体荧光显像技术在甲状腺手术中的应用

Based on probe near-infrared autofluorescence imaging technique of parathyroid gland application in thyroid surgeryy

目的探讨基于探针式甲状旁腺近红外自体荧光显像技术(near-infrared autofluorescence imaging,NIRAF)的有效性。方法选取2023年5月4日至2023年5月26日符合收治条件的甲状腺癌患者共71例,其中中国人民解放军总医院第一医学中心普通外科医学部甲状腺(疝)外科甲状腺癌人组42例,女29例,男13例,中位年龄41岁,范围21~76岁;广州市第一人民医院甲状腺外科甲状腺癌人组29例,女22例,男7例,中位年龄42.5岁,范围24~72岁。随访周期1个月。结果肉眼识别可疑甲状旁腺组织196枚,基于探针式NIRAF技术识别可疑甲状旁腺组织207枚,肉眼识别甲状旁腺组织的灵敏度84.86%、特异度56%、准确度81.89%,探针式NIRAF技术识别甲状旁腺组织的灵敏度92.66%、特异度80.00%、准确度90.53%,优于肉眼识别,与免疫胶体金试验或术中冰冻病理结果有较好符合率(Kappa=0.61,P<0.001)。结论基于探针式NIRAF技术对甲状旁腺组织具有较好的识别能力。

Objective To investigate the effectiveness of probe-based near-infrared autofluorescence im-aging(NIRAF)of the parathyroid gland.Methods A total of 71 patients with thyroid cancer eligible for admis-sion from May 4,2023 to May 26,2023 were selected,including 42 patients with thyroid cancer enrolled in the De-partment of Thyroid(hernia),Department of General Surgery,PLA General Hospital,including 29 females and 13 males,with a median age of 41 years,ranging from 21 to 76 years.A total of 29 patients with thyroid cancer were enrolled in the Department of Thyroid Surgery of Guangzhou First People's Hospital,including 22 females and 7 males.The median age was 42.5 years,ranging from 24 to 72 years.The follow-up period was 1 month.Results Among them,196 suspicious parathyroid tissues were identified by the naked eye,and 207 suspicious parathyroid tissues were identified by probe NIRAF technology.Naked eye identification sensitivity,specificity and accuracy were 84.86%,56% and 81.89%.The sensitivity,specificity and accuracy of parathyroid tissue identification by probe NIRAF were 92.66%,80.00% and 90.53%,which were better than that of naked eye identification,and had a good coincidence rate with the results of immunocolloidal gold test or intraoperative freezing pathology(Kappa=0.61,P<0.001).Conclusion n The probe-based NIRAF technique has a good ability to identify parathyroid tissue.