Clinical application of carbon nanoparticle lymph node tracer in the VI region lymph node dissection of differentiated thyroid cancer

Sun, Shanping; Zhang, Y.; Cui, Zhaoqing; Chen, Q.; Zhang, W.; Zhou, Chang‐Xin; Xie, Panpan; Liu, B.G.

doi:10.4238/2014.april.30.4

Cited by 16 publications

(23 citation statements)

References 2 publications

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“…The authors concluded that the CNs method better aided the screening and selection of patients who are most likely to benefit from cervical lymph node dissection (37). CNs stain the majority of lymph nodes, with the reported rate of CN staining was 69.89-95.26% (20,37,38), with the black-staining rate in the present study being 84.90%. More lymph nodes <5 mm were detected with the assistance of CNs, which cannot be easily recognized without any assistance.…”

Section: Discussionsupporting

confidence: 45%

Carbon nanoparticles guide contralateral central neck dissection in patients with papillary thyroid cancer

Sun

et al. 2018

Oncol Lett

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The treatment of contralateral central neck lymph node metastasis is controversial in patients with papillary thyroid cancer. The present study reports the use of carbon nanoparticles (CNs) as lymph node tracers and discusses the potential role of predicting contralateral central neck metastasis is evaluated, so as to guide contralateral central neck dissection (CND). A total of 70 consecutive patients with papillary thyroid cancer were enrolled in the present study. All patients underwent a total or near-total thyroidectomy plus bilateral CND, during which CNs were used as a lymph node tracer. Of the 70 enrolled patients, 51 (72.86%) were confirmed to have lymph node metastasis in the central neck, 50 (71.43%) patients in the ipsilateral central neck and 14 (20.00%) in the contralateral central neck. A total of 579 (84.90%) lymph nodes were stained black by CNs. Of the 193 metastatic lymph nodes, 168 were located in the ipsilateral central compartment and the other 25 in the contralateral central compartment. A total of 147 (76.17%) metastatic lymph nodes were stained black. A total of 21 metastatic lymph nodes were found in the contralateral central compartment, 4 metastatic lymph nodes of contralateral central compartment were not black-stained. The sensitivity and specificity of CNs for contralateral metastasis was 84 and 25%, respectively. Contralateral central lymph node metastasis was significantly associated with extrathyroid extension and the presence of ipsilateral central neck lymph node metastasis. Together, the results of the present study reveal that CNs might accurately predict contralateral central lymph nodes metastasis and could be used to direct CND.

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Section: Discussionsupporting

confidence: 45%

Carbon nanoparticles guide contralateral central neck dissection in patients with papillary thyroid cancer

Sun

et al. 2018

Oncol Lett

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“…Hence, the number of metastatic lymph nodes in the CN group was statistically higher than that in the blank control group. Besides, 4 studies reported that the number of retrieved small lymph nodes (diameter <5 mm) was significantly higher in the CN group 44,60,61,67. These findings suggest that CNs may help identify tiny, suspicious lymph nodes.…”

Section: Resultsmentioning

confidence: 91%

“…According to the search strategy, 149 references were obtained, and 47 RCTs met the inclusion criteria 18,19,23–67. The flowchart of the literature search is shown in Figure 3.…”

Section: Resultsmentioning

confidence: 99%

Application of carbon nanoparticles in lymph node dissection and parathyroid protection during thyroid cancer surgeries: a systematic review and meta-analysis

Wang¹,

Yang²,

Lv³

et al. 2017

OTT

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PurposeTo investigate whether carbon nanoparticles (CNs) are helpful in identifying lymph nodes and metastatic lymph nodes and in parathyroid protection during thyroid cancer surgery.MethodsEnglish and Chinese literature in PubMed, Cochrane Database of Systematic Reviews, EMBASE, ClinicalTrials.gov, China Biology Medicine Database, China National Knowledge Infrastructure, China Master’s and Doctoral Theses Full-Text Database, Wanfang database, and Cqvip database were searched (till March 22, 2016). Randomized controlled trials (RCTs) that compared the use of CNs with a blank control in patients undergoing thyroid cancer surgery were included. Quality assessment and data extraction were performed, and a meta-analysis was conducted using RevMan 5.1 software. The primary outcomes were the number of retrieved central lymph nodes and metastatic lymph nodes, and the rate of accidental parathyroid removal.ResultsWe obtained 149 relevant studies, and only 47 RCTs with 4,605 patients (CN group: n=2,197; blank control group: n=2,408) met the inclusion criteria. Compared with the control group, the CN group was associated with more retrieved lymph nodes/patient (weighted mean difference [WMD]: 3.39, 95% confidence interval [CI]: 2.73–4.05), more retrieved metastatic lymph nodes (WMD: 0.98, 95% CI: 0.61–1.35), lower rate of accidental parathyroid removal, and lower rates of hypoparathyroidism and hypocalcemia. However, the total metastatic rate of the retrieved lymph nodes did not differ between the groups (odds ratio: 1.13, 95% CI: 0.87–1.47, P=0.35).ConclusionCNs can improve the extent of neck dissection and protect the parathyroid glands during thyroid cancer surgery. And the number of identified metastatic lymph nodes can be simultaneously increased.

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“…[6–11] In recent years, they are commonly used as intraoperative localization for thyroid cancer, which would bring extraoperative procedure. [12,13] Preoperative ultrasound-guided CNs localization will improve this disadvantage. Therefore, we conducted a retrospective cohort study to evaluate the effectiveness and safety of reoperative ultrasound-guided CNs localization.…”

Section: Introductionmentioning

confidence: 99%

Preoperative ultrasound-guided carbon nanoparticles localization for metastatic lymph nodes in papillary thyroid carcinoma during reoperation

Zhao¹,

Luo²,

Zhou

et al. 2017

Medicine

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Due to the damaged anatomical structure and a large amount of fibrous and scar tissues in the surgical field, reoperation of papillary thyroid carcinoma is difficult. This study introduces a new method of locating metastatic lymph nodes during reoperation and evaluates the effectiveness and safety of the preoperative ultrasound-guided carbon nanoparticles (CNs) localization. This retrospective cohort study enrolled 52 patients who were diagnosed with lymph node metastasis by histopathology and underwent reoperation from October 2015 to February 2016. The modified radical neck dissection or selective neck node dissection was performed. A total of 26 patients underwent preoperative ultrasound-guided CNs injection, and other 26 patients did not. Tolerance, the result of injection, the number of resected metastatic lymph nodes, and postoperative complications were recorded and analyzed. In CNs group, 102 suspicious nonpalpable lesions in 26 patients were injected with CNs, and 99 of the 102 lesions were successfully identified by surgeon in the reoperation. The positive rate of resected lymph nodes in total, in the central compartment, and in the lateral compartment were 31.6%, 31.2%, and 32.8%, respectively, which was significantly higher than that in the control group (P < 0.001, P < 0.001, and P = 0.041). In addition, the positive rates of levels III, IV, and V in the CNs group were 35.6%, 21.9%, and 30.5%, respectively, which was significantly higher than that in the control group (P < 0.001, P = 0.005, and P = 0.01). In additional, in the CNs group, the rate of temporary hypoparathyroidism was significantly lower compared with the control group (0% vs 26.9%, P = 0.021). Preoperative ultrasound-guided CNs injection is a safe and effective method for localization of the metastatic lymph nodes during reoperation.

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Clinical application of carbon nanoparticle lymph node tracer in the VI region lymph node dissection of differentiated thyroid cancer

Cited by 16 publications

References 2 publications

Carbon nanoparticles guide contralateral central neck dissection in patients with papillary thyroid cancer

Carbon nanoparticles guide contralateral central neck dissection in patients with papillary thyroid cancer

Application of carbon nanoparticles in lymph node dissection and parathyroid protection during thyroid cancer surgeries: a systematic review and meta-analysis

Preoperative ultrasound-guided carbon nanoparticles localization for metastatic lymph nodes in papillary thyroid carcinoma during reoperation

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