Recognition of sentinel lymph nodes in patients with papillary thyroid cancer by nano-carbon and methylene blue.

Fangzhou Liu,Yu Zhang,Yuan Zhang,Jia Zhang,Yichuan Qian,Yan Zhu

doi:10.12669/pjms.336.13940

Fangzhou Liu, Yu Zhang + Show 4 more

Open Access

https://doi.org/10.12669/pjms.336.13940

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Abstract

Objective:To compare the accuracy and feasibility of methylene blue and nano-carbon in clinical tracing of sentinel lymph nodes (SLNs) in patients with papillary thyroid cancer (PTC).Methods:Ninety-six PTC patients were selected and randomly divided into a methylene blue group and a nano-carbon group (n=48). During surgery, tracer agent was injected around the tumor, and SLNs were resected and subjected to frozen pathological examination. The results were compared with those of routine pathological examination after surgery.Results:Latent lymph node metastasis (level VI and lateral neck) was detected in both groups, with neck distribution of SLNs. There was no significant difference in the detection rate or accuracy of SLNs between two groups (P>0.05). The incorrect resection rate of parathyroid gland and incidence of temporary hypoparathyroidism in the methylene blue group were significantly higher than those of the nano-carbon group (t=4.137, P<0.05).Conclusions:The state of PTC lymph nodes can be well evaluated by SLN biopsy using both methylene blue and nano-carbon as tracers, but using nano-carbon has a lower incidence rate of parathyroid injury, with great clinical prospects accordingly.

Highlights

Papillary thyroid cancer (PTC), despite with the lowest degree of malignancy, accounts for about 85% of thyroid tumors, but its incidence has been increasing annually
Sentinel lymph nodes (SLNs) first drain lymph of primary cancer in local tissues, biopsy for which can accurately predict the state of regional lymph nodes.[3]
At the 3, 6, 9- and 12-o’clock positions about 1-2 mm around the tumor, 0.2-0.8 mL of 10 g/L methylene blue was injected for the methylene blue group and 1 mL of nano-carbon suspension was injected for the nanocarbon group using a 1 mL syringe

Summary

Introduction

Papillary thyroid cancer (PTC), despite with the lowest degree of malignancy, accounts for about 85% of thyroid tumors, but its incidence has been increasing annually. It has become the fifth susceptible malignancy for females, which mostly endangers children or young women, with an uncertain age of onset.[1,2] Sentinel lymph nodes (SLNs) first drain lymph of primary cancer in local tissues, biopsy for which can accurately predict the state of regional lymph nodes.[3]. Researchers have endeavored to carry out SLN biopsy for melanoma, breast cancer, penile cancer and colon cancer, providing a scientific basis for determining the surgical range.[4] SLNs of thyroid cancer have seldom been studied.

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