The Applied Significance of Carbon Nanoparticles in Central Compartment Lymph Node Dissection in Treatment of cN0 Papillary Thyroid Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Zhifang , YUE Ruixue , ZHU Zhi , LU Chao , XIA Wenfei , YI Jilin ,  LI Xingrui

Department of Thyroid and Breast Surgery， Tongji Hospital of Tongji Medical College， Huazhong University of Science and Technology， Wuhan 430030， Hubei Province， China;

Corresponding author：

LI Xingrui, Email: lixinguri07@gmail.com

Keywords：

Carbon nanoparticles; Papillary thyroid carcinoma; Lymphatic tracer; Lymph node metastasis

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Objective 　To assess the applied significance of carbon nanoparticles in central compartment lymph node dissection in treatment of cN0 papillary thyroid carcinoma.
Methods 　Sixty-eight patients with cN0 papillary thyroid carcinoma who were treated in Tongji Hospital of Tongji Medical College from May. to Oct. in 2012 were randomly allocated to the control group （n=32） and the carbon nanoparticles trace group （tracer group， n=36）， receiving non-carbon nanoparticles trace and carbon nanoparticles trace respectively. All patients were received total resection of thyroid plus the affected side and （or） contralateral side central compartment lymph node dissection. The lymph node-related indexes（including number of dissected lymph node at Ⅵarea and lymph node metastasis rate at Ⅵarea） and operative indexs （including operation time， blood loss， drainage time， complication， and hospital stay） were collected and compared between the 2 groups.
Results 　There were 205 and 324 dissected lymph node at central compartment in control group and tracer group respectively. The results of postoperative pathology showed that the number of lymph node in central compartment of the tracer group was much more than those of control group （8.99±2.24 vs. 6.41±1.56， P＜0.001）. The metastasis rate of central compartment lymph node were 40.6% （13/32） in control group and 47.2% （17/36） in tracer group， but there was no significant difference between the 2 groups （P=0.762）. But in medial area of laryngeal recurrent nerve， the metastasis rate in the tracer group （38.9%， 14/36） was much higher than those of control group （12.5%， 4/32）， P=0.029. There were no significant differences in the operation time， blood loss， drainage time， hospital stay， and complication incidence such as bleeding， temporary hypocalcemia， and injury of superior laryngeal nerve between 2 groups （P＞0.05）. All the patients in 2 groups had followed-up for 6 months without death， recurrence， and metastasis.
Conclusions 　The lymphatic tracer technique of carbon nanoparticles may improve the number of dissected lymph nodes in central region of cN0 papillary thyroid carcinoma， without increasing （or prolonging） operation time， intraoperative blood loss， and postoperative hospital stay， and can accurately represent the metastasis of lymph node， thus to make the staging of the tumor accurately and guide postoperative treatment.

Citation： YANG Zhifang,YUE Ruixue,ZHU Zhi,LU Chao,XIA Wenfei,YI Jilin,LI Xingrui,.. The Applied Significance of Carbon Nanoparticles in Central Compartment Lymph Node Dissection in Treatment of cN0 Papillary Thyroid Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(9): 976-980. doi: Copy

1.	Cooper DS， Doherty GM， Haugen BR， et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J]. Thyroid， 2006， 16(2)：109-142.
2.	Dănilă R， Popovici R， Andriescu L， et al. The role of lymphadenectomy in the treatment of differentiated thyroid cancer[J]. Rev Med Chir Soc Med Nat Iasi， 2007， 111(1)：129-134.
3.	周学兵，王炜，程锁利. 乳头状甲状腺癌颈部淋巴结转移规律分析[J]. 当代医学， 2012， 18(14)：103-104.
4.	Sebastian SO， Gonzalez JM， Paricio PP， et al. Papillary thyroid carcinoma：prognostic index for survival including the histological variety[J]. Arch Surg， 2000， 135(3)：272-277.
5.	Sywak M， Cornford L， Roach P， et al. Routine ipsilateral level Ⅵ lymphadenectomy reduces postoperative thyroglobulin levels in papillary thyroid cancer[J]. Surgery， 2006， 140(6)：1000-1005.
6.	Pereira JA， Jimeno J， Miquel J， et al. Nodal yield， morbidity， and recurrence after central neck dissection for papillary thyroid carcinoma[J]. Surgery， 2005， 138(6)：1095-1100.
7.	李思荣，吴青松，丘昶儒，等. cN0期分化型甲状腺癌行中央区淋巴结清扫及预防性侧颈淋巴结清扫的价值[J]. 新医学， 2012， 43(3)：167-169.
8.	朱永学，王弘士，吴毅，等. 甲状腺乳头状癌Ⅵ区淋巴结的归属[J]. 中华外科杂志， 2004， 42(14)：867-869.
9.	吴毅. 中央区淋巴结清扫术用于分化型甲状腺癌治疗[J]. 中国实用外科杂志， 2010， 30(10)：898， 904.
10.	Shindo M， Wu JC， Park EE， et al. The importance of central compartment elective lymph node excision in the staging and treatment of papillary thyroid cancer[J]. Arch Otolaryngol Head Neck Surg， 2006， 132(6)：650-654.
11.	Caglià P， Zappulla E， Costa S， et al. Differentiated thyroidcancer：role of the lymph node dissection[J]. G Chir， 2010， 31(6-7)：293-295.
12.	Palestini N， Borasi A， Cestino L， et al. Is central neck dissection a safe procedure in the treatment of papillary thyroid cancer? Our experience[J]. Langenbecks Arch Surg， 2008， 393(5)：693-698.
13.	Fritze D， Doherty GM. Surgical management of cervical lymph nodes in differentiated thyroid cancer[J]. Otolaryngol Clin North Am， 2010， 43(2)：285-300.
14.	李树玲. 头颈肿瘤学[M]. 天津：天津科学技术出版社， 1993：739-745.
15.	Caron NR， Clark OH. Papillary thyroid cancer：surgical manage-ment of lymph node metastases[J]. Curr Treat Options Oncol， 2005， 6(4)：311-322.
16.	沈强，田敖龙，屈海欧. 保留颈丛的功能性颈清扫术在分化性甲状腺癌治疗上的应用[J]. 中国癌症杂志， 2001， 11(4)：361-363.
17.	梁正新，罗文政，周何强，等. 颈部低位切口行中央区及侧颈淋巴清扫治疗甲状腺癌cN0患者临床分析[J]. 江西医药， 2012， 47(11)：964-965.
18.	郭卫平，李玺，邱万寿，等. 预防性中央区淋巴结清扫在cN0乳头状甲状腺癌的临床价值[J]. 中华全科医学， 2010， 8(10)：1215-1216.
19.	Caliskan M， Park JH， Jeong JS， et al. Role of prophylactic ipsil-ateral central compartment lymph node dissection in papillary thyroid microcarcinoma[J]. Endocr J， 2012， 59(4)：305-311.
20.	Lundgren CI， Hall P， Dickman PW， et al. Clinically significantprognostic factors for differentiated thyroid carcinoma：a population-based， nested case-control study[J]. Cancer， 2006， 106(3)：524-531.
21.	Podnos YD， Smith D， Wagman LD， et al. The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer[J]. Am Surg， 2005， 71(9)：731-734.
22.	江国斌，方红燕，蔡建明. 纳米碳混悬液示踪前哨淋巴结在甲状腺乳头状癌中的应用[J]. 中国癌症杂志， 2010， 20(12)：938-940.
23.	苏力夫，张生彬，朱永蒙. 纳米碳示踪前哨淋巴结在cN0甲状腺乳头状癌中的应用[J]. 中国现代医学杂志， 2013， 23(7)：110-112.
24.	马云海，钱军，曾玉剑，等. 甲状腺癌根治术中应用纳米碳分辨和保护甲状旁腺[J]. 昆明医学院学报， 2011， 32(4)：68-70.
25.	王丹，宋永蔚. 纳米碳在甲状腺癌淋巴结清扫时鉴别和保护甲状旁腺的作用[J]. 当代医学， 2013， 19(6)：40.
26.	黄韬. 甲状旁腺术中损伤的预防和处理[J]. 中国实用外科杂志， 2008， 28(3)：179-180.

1. Cooper DS， Doherty GM， Haugen BR， et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J]. Thyroid， 2006， 16(2)：109-142.
2. Dănilă R， Popovici R， Andriescu L， et al. The role of lymphadenectomy in the treatment of differentiated thyroid cancer[J]. Rev Med Chir Soc Med Nat Iasi， 2007， 111(1)：129-134.
3. 周学兵，王炜，程锁利. 乳头状甲状腺癌颈部淋巴结转移规律分析[J]. 当代医学， 2012， 18(14)：103-104.
4. Sebastian SO， Gonzalez JM， Paricio PP， et al. Papillary thyroid carcinoma：prognostic index for survival including the histological variety[J]. Arch Surg， 2000， 135(3)：272-277.
5. Sywak M， Cornford L， Roach P， et al. Routine ipsilateral level Ⅵ lymphadenectomy reduces postoperative thyroglobulin levels in papillary thyroid cancer[J]. Surgery， 2006， 140(6)：1000-1005.
6. Pereira JA， Jimeno J， Miquel J， et al. Nodal yield， morbidity， and recurrence after central neck dissection for papillary thyroid carcinoma[J]. Surgery， 2005， 138(6)：1095-1100.
7. 李思荣，吴青松，丘昶儒，等. cN0期分化型甲状腺癌行中央区淋巴结清扫及预防性侧颈淋巴结清扫的价值[J]. 新医学， 2012， 43(3)：167-169.
8. 朱永学，王弘士，吴毅，等. 甲状腺乳头状癌Ⅵ区淋巴结的归属[J]. 中华外科杂志， 2004， 42(14)：867-869.
9. 吴毅. 中央区淋巴结清扫术用于分化型甲状腺癌治疗[J]. 中国实用外科杂志， 2010， 30(10)：898， 904.
10. Shindo M， Wu JC， Park EE， et al. The importance of central compartment elective lymph node excision in the staging and treatment of papillary thyroid cancer[J]. Arch Otolaryngol Head Neck Surg， 2006， 132(6)：650-654.
11. Caglià P， Zappulla E， Costa S， et al. Differentiated thyroidcancer：role of the lymph node dissection[J]. G Chir， 2010， 31(6-7)：293-295.
12. Palestini N， Borasi A， Cestino L， et al. Is central neck dissection a safe procedure in the treatment of papillary thyroid cancer? Our experience[J]. Langenbecks Arch Surg， 2008， 393(5)：693-698.
13. Fritze D， Doherty GM. Surgical management of cervical lymph nodes in differentiated thyroid cancer[J]. Otolaryngol Clin North Am， 2010， 43(2)：285-300.
14. 李树玲. 头颈肿瘤学[M]. 天津：天津科学技术出版社， 1993：739-745.
15. Caron NR， Clark OH. Papillary thyroid cancer：surgical manage-ment of lymph node metastases[J]. Curr Treat Options Oncol， 2005， 6(4)：311-322.
16. 沈强，田敖龙，屈海欧. 保留颈丛的功能性颈清扫术在分化性甲状腺癌治疗上的应用[J]. 中国癌症杂志， 2001， 11(4)：361-363.
17. 梁正新，罗文政，周何强，等. 颈部低位切口行中央区及侧颈淋巴清扫治疗甲状腺癌cN0患者临床分析[J]. 江西医药， 2012， 47(11)：964-965.
18. 郭卫平，李玺，邱万寿，等. 预防性中央区淋巴结清扫在cN0乳头状甲状腺癌的临床价值[J]. 中华全科医学， 2010， 8(10)：1215-1216.
19. Caliskan M， Park JH， Jeong JS， et al. Role of prophylactic ipsil-ateral central compartment lymph node dissection in papillary thyroid microcarcinoma[J]. Endocr J， 2012， 59(4)：305-311.
20. Lundgren CI， Hall P， Dickman PW， et al. Clinically significantprognostic factors for differentiated thyroid carcinoma：a population-based， nested case-control study[J]. Cancer， 2006， 106(3)：524-531.
21. Podnos YD， Smith D， Wagman LD， et al. The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer[J]. Am Surg， 2005， 71(9)：731-734.
22. 江国斌，方红燕，蔡建明. 纳米碳混悬液示踪前哨淋巴结在甲状腺乳头状癌中的应用[J]. 中国癌症杂志， 2010， 20(12)：938-940.
23. 苏力夫，张生彬，朱永蒙. 纳米碳示踪前哨淋巴结在cN0甲状腺乳头状癌中的应用[J]. 中国现代医学杂志， 2013， 23(7)：110-112.
24. 马云海，钱军，曾玉剑，等. 甲状腺癌根治术中应用纳米碳分辨和保护甲状旁腺[J]. 昆明医学院学报， 2011， 32(4)：68-70.
25. 王丹，宋永蔚. 纳米碳在甲状腺癌淋巴结清扫时鉴别和保护甲状旁腺的作用[J]. 当代医学， 2013， 19(6)：40.
26. 黄韬. 甲状旁腺术中损伤的预防和处理[J]. 中国实用外科杂志， 2008， 28(3)：179-180.

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The Applied Significance of Carbon Nanoparticles in Central Compartment Lymph Node Dissection in Treatment of cN0 Papillary Thyroid Carcinoma

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