Page 111 - 南京医科大学学报自然科学版

第43卷第8期 南京医科大学学报（自然科学版）
2023年8月 Journal of Nanjing Medical University（Natural Sciences） ·1145 ·

·临床研究·

术前超声引导下甲状腺内注射纳米碳颗粒在甲状腺乳头状癌

中央区淋巴结清扫中的应用

王 莹，施杲旸，陆 辉，蒋 军 *
南京医科大学第一附属医院普外科，江苏 南京 210029

［摘 要］ 目的：从中央区淋巴结数目及染色情况、纳米碳外溢等方面，比较甲状腺乳头状癌术前超声引导下注射与术中注射
纳米碳悬浊液两种不同操作方法的差异，以探寻更优的示踪方法。方法：选取227例甲状腺乳头状癌患者，随机分为术前超声
引导注射组106例和术中注射组121例。分析两组患者中央区各亚区淋巴结（颈白线淋巴结、喉前淋巴结、气管前及气管旁淋
巴结）数目及染色情况。结果：术前超声引导注射组纳米碳外溢比例低于术中注射组。术前注射组患者颈白线淋巴结数目、气
管前及气管旁淋巴结数目均多于术中注射组相应区域淋巴结数目（P＜0.05）。伴桥本氏甲状腺炎患者、术前评估中央区淋巴
结异常（central lymph node positive，cN1）者、肿瘤直径＞1 cm者，术前超声引导注射纳米碳，中央区淋巴结黑染比例更高（P＜
0.05）。结论：甲状腺乳头状癌术前超声引导注射纳米碳可减少术中染料外溢，提高中央区淋巴结的黑染率和检出率。
［关键词］ 甲状腺乳头状癌；中央区淋巴结；纳米碳
［中图分类号］ R736.1 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）08⁃1145⁃06
doi：10.7655/NYDXBNS20230816

Application of preoperative ultrasound guided injection of nano ⁃ carbon in central lymph
node dissection of papillary thyroid carcinoma

WANG Ying，SHI Gaoyang，LU Hui，JIANG Jun *
Department of General Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To explore a better tracing method of central lymph nodes in papillary thyroid cancer patients by comparing
the numbers and staining rate of central lymph nodes between preoperative ultrasound⁃guided injection and intraoperative injection of
nano ⁃ carbon. Methods：A total of 227 patients were randomly enrolled into preoperative ultrasoundguided injection group and
intraoperative injection group. The rate of dye spillover，the numbers and staining rate of the lymph nodes in each sub⁃area of central
region（linea alba cervical lymph nodes，prelaryngeal lymph nodes，pretracheal and paratracheal lymph nodes）were recorded and
analyzed. Results：The proportion of nano ⁃ carbon spillover in precperative ultrasound guided injection was lower than that in the
intraoperative injection group；while central lymph nodes，pretracheal and paratracheal lymph nodes were more in the preoperative
injection group than in the intraoperative injection group（P＜0.05）. For patients with Hashimoto’s thyroiditis，with metastatic central
lymph nodes accessed preoperatively，with a tumor diameter more than 1 cm，central lymph nodes were more accessible to be stained
by preoperative injection of nano⁃carbon（P＜0.05）. Conclusion：Preoperative ultrasound guided injection of nano⁃carbon can reduce
dye spillover and improve the staining rate and detection rate of central lymph nodes.
［Key words］ papillary thyroid carcinoma；central lymph nodes；nano⁃carbon
［J Nanjing Med Univ，2023，43（08）：1145⁃1149，1155］

近年，甲状腺癌发病率呈逐渐上升趋势，已成 为最常见的内分泌系统恶性肿瘤之一。其中最常

见的病理类型为甲状腺乳头状癌（papillary thyroid
［1］
［基金项目］ 国家自然科学基金（81972486） cancer，PTC），约占甲状腺癌总数的 90% 。PTC 易
∗ 发生早期淋巴结转移。据报道，有20%~90%的患者
通信作者（Corresponding author），E⁃mail：junjiang@njmu.edu.cn