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中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (06) : 462 -465. doi: 10.3877/cma.j.issn.1674-3946.2018.06.004

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分化型甲状腺癌术中纳米碳示踪对颈淋巴结清扫的指导意义
杜峻峰1, 安然2, 李世拥1,()   
  1. 1. 100700 北京,中国人民解放军总医院第七医学中心普通外科
    2. 100700 北京,中国人民解放军总医院病理科
  • 收稿日期:2018-08-31 出版日期:2018-12-26
  • 通信作者: 李世拥

Clinical Significance of Carbon Nanoparticles in Guiding Neck Dissection in the Surgical Treatment of Differentiated Thyroid Cancer

Junfeng Du1, Ran An2, Shiyong Li1,()   

  1. 1. Department of General Surgery, 7th Medical Center of PLA General Hospital Beijing 100700, China
    2. Department of Pathology, 7th Medical Center of PLA General Hospital Beijing 100700, China
  • Received:2018-08-31 Published:2018-12-26
  • Corresponding author: Shiyong Li
  • About author:
    Corresponding author: Li Shiyong, Email:
  • Supported by:
    National Natural Science Foundation of China(81870393, 81571563)
引用本文:

杜峻峰, 安然, 李世拥. 分化型甲状腺癌术中纳米碳示踪对颈淋巴结清扫的指导意义[J/OL]. 中华普外科手术学杂志(电子版), 2018, 12(06): 462-465.

Junfeng Du, Ran An, Shiyong Li. Clinical Significance of Carbon Nanoparticles in Guiding Neck Dissection in the Surgical Treatment of Differentiated Thyroid Cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(06): 462-465.

分化型甲状腺癌是临床最为常见的恶性肿瘤之一,完整的外科手术切除是决定预后的重要因素,残余的转移淋巴结是术后复发的高危因素,淋巴结的彻底清扫可以改善总体预后。然而对于甲状腺癌的预防性/治疗性颈淋巴结清扫术尚存争议及挑战。纳±3碳混悬液作为新型的淋巴结示踪剂,对于甲状腺的淋巴结具有良好的示踪效果,可以显著提高术中的清扫效率,增加获取淋巴结的数目,更为准确地判断分期及预后。另外通过其"负显影"的特性可以有效保护喉返神经、甲状旁腺等重要结构,显著降低颈部淋巴结清扫中并发症的发生率,具有重要的临床意义。

Differentiated thyroid cancer (DTC) is one of the most common cancer in China. Thyroidectomy combined with radical neck dissection is still the curative therapy for patients with DTC, with low incidence of recurrence and improved prognosis. However, there are some controveries about the extent and neccessarity of either preventive or curative neck dissection in the surgical treatment of DTC. The carbon nanoparticle is a new lymph tracer with a clear lymphatic mapping and a longer time of dying. This lymphatic tracer technique could improve the dissection of central compartment lymph node lymph nodes, while protecting parathyroid gland from false resection and decreasing the incidence of RLN injury and postoperative hypocalcemia, with important clinical significance.

图2 黑染的中央区淋巴结
图4 未被染黑的喉返神经
图6 黑染的转移性淋巴结
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