scholarly journals Preliminary Study on the Clinical Significance and Methods of Using Carbon Nanoparticles in Endoscopic Papillary Thyroid Cancer Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Shangrui Rao ◽  
Zhonglin Wang ◽  
Congtao Pan ◽  
Yi Wang ◽  
Zhe Lin ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Clinical Significance ◽  
Carbon Nanoparticles ◽  
Detection Rate ◽  
Control Group ◽  
Papillary Thyroid ◽  
Injection Group ◽  
Significant Difference ◽  
Preliminary Study

Purpose. The purpose of this study was to find the clinical significance and methods of using CN in endoscopic treatment for PTC. Materials and Methods. A total of 108 cases were randomly enrolled and divided into two groups, with 50 cases in the CN injection group who were injected with CN and 58 cases in the control group with no CN injection. All cases were analyzed with the size of carcinoma, the number of lymph node, and parathyroid gland injury. Results. All operations were successfully completed. The lymph node dissection number was 274 for the control group and 322 (the rate of black stained was 87%) for the CN injection group. The average number of lymph nodes in the CN injection group was 6.44 ± 2.08, which was significantly higher than that in the control group (4.72 ± 1.89). The control group had a relatively higher incidence of incidental parathyroidectomy, compared to the CN injection group (27.6% in the control group vs. 12% in the CN injection group, P = 0.045 ). However, the incidence of hypoparathyroidism failed to show the significant difference between the two groups. Conclusion. Using CN in endoscopic PTC surgery could increase the detection rate of lymph nodes and reduce the injury of parathyroid glands to a certain extent.

scholarly journals Incidence and Clinical Significance of Delphian Lymph Node Metastasis in Unilateral Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Wei Liu ◽  
Zhenglin Wang ◽  
Cong Wang ◽  
Zhilong Ai
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Clinical Significance ◽  
Tumor Size ◽  
Frozen Section ◽  
Extrathyroidal Extension ◽  
Capsular Invasion ◽  
Papillary Thyroid

Abstract Background: Some studies have reported that Delphian lymph node (DLN) metastasis is associated with a poor prognosis of papillary thyroid carcinoma (PTC), but the number of the available studies is limited and the results are inconsistent. The aim of this investigation was to study the incidence and clinical significance of DLN metastasis in patients with unilateral PTC.Methods: This was a cross-sectional study from January 2016 to December 2019. The data were obtained from the department of general surgery in Shanghai Zhongshan Hospital affiliated to Fudan University. This study included 522 patients with unilateral PTC and had DLN harvested. The associations between DLN metastasis and the clinical characteristics of the patients, i.e. age, sex, tumor size, multifocality, capsular invasion, extrathyroidal extension, central lymph nodes (CLN) metastasis (excluding DLN), and lateral lymph nodes (LLN) metastasis was analyzed.Results: Among all the 522 patients, 133 (25.5%) patients had metastasized DLN lymph nodes. DLN metastasis was significantly associated with age (p = 0.047), male (p < 0.001), larger tumor size (p < 0.001), capsular invasion (p < 0.001), extrathyroidal extension (p = 0.004), tumor location in upper third (p = 0.003), other CLN metastasis (p < 0.001), number of positive CLN (excluding DLN) (p < 0.001), LLN metastasis (p = 0.036), number of positive LLN (p = 0.004) and number of DLN removed (p = 0.043). No association was found between DLN metastasis and multifocality, number of CLN removed and number of LLN removed.Conclusions: DLN metastasis is associated with some adverse prognostic markers of PTC. If the DLN is positive on intraoperative frozen section, careful dissection of CLN and careful evaluation of LLN are essential, and intensive follow-up should be warranted.

scholarly journals The Role of Carbon Nanoparticle in Lymph Node Detection and Parathyroid Gland Protection during Thyroidectomy- a Meta Analysis

2019 ◽  
Author(s):  
Shao-Wei Xu ◽  
Zhi-Feng Li ◽  
Man-Bin Xu ◽  
Han-Wei Peng
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Parathyroid Gland ◽  
Carbon Nanoparticles ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Initial Surgery ◽  
Significant Difference ◽  
Transient Hypoparathyroidism

AbstractObjectiveTo assess the efficiency of the carbon nanoparticles (CNs) in lymph node identification and parathyroid gland protection during thyroidectomy.MethodsA systematic literature search for relevant literatures published up to December 2018 in PubMed, Embase, Web of Science and Cochrane Library was performed. Both English and Chinese literatures were retrieved and analyzed. Randomized controlled trials or nonrandomized controlled trials on the use of CNs during thyroidectomy were enrolled in this study. The primary outcomes included the number of lymph nodes harvesed, rate of lymph nodes involvement, and the rates of accidental parathyroidectomy, hypoparathyroidism, and hypocalcemia. Weighted mean differences (WMDs), odds ratios (ORs) and risk differences (RDs) were calculated for the dichotomous outcome variables. Between-study heterogeneity was tested using the Q tests and the I2 statistics. All analyses were performed using Review Manager (version 5.3.5).Results25 studies comprising 3266 patients were included in this analysis. The total number of lymph nodes harvested in the groups of carbon nanoparticles was significant higher than that in the control groups (WMD, 2.36; 95% CI, 1.40 to 3.32; P <0.01). Administrating carbon nanoparticles was associated with a lower incidence of accidental parathyroid gland removal (OR = 0.30, 95% CI = 0.23 to 0.40, P <0.01) and lower rates of both postoperative transient hypoparathyroidism (OR =0.46, 95% CI = 0.33 to 0.64, P <0.01) and transient hypocalcemia (OR =0.55, 95% CI = 0.09 to 3.43, P =0.52). There was no significant difference of identified lymph node metastatic rates between the patients with and without use of carbon nanoparticles. Subgroup analyses indicated that the application of CNs in thyroid cancer reoperation also decreased the rate of transient hypoparathyroidism (OR =0.20, 95% CI = 0.36 to 0.04, P =0.01) and the possibility of accidental parathyroid glands removal (OR = 0.19, 95% CI = 0.05 to 0.73, P<0.05).ConclusionsThe application of CNs for thyroidectomy results in higher number of lymph node harvested and better parathyroid gland protection during initial surgery and reoperation for thyroid cancer.

scholarly journals Application of Carbon Nanoparticles in Neck Dissection of Clinically Node-Negative Papillary Thyroid Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Zhongyan Chen ◽  
Zhiming Zhong ◽  
Guoqing Chen ◽  
Yun Feng
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Neck Dissection ◽  
Carbon Nanoparticles ◽  
Control Group ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Node Negative

Purpose. The purpose of this retrospective study was to evaluate the advantages of carbon nanoparticles in neck dissection and to conclude its application in the treatment of clinically node-negative papillary thyroid carcinoma (CN0PTC). Methods. As a retrospective cohort study, we divided the enrolled patients into two groups, the carbon nanoparticle (CN) group and the control group according to the usage of CN. In the CN group, CN was applied to reveal drainage lymph nodes and the picked LNs were sent for fast frozen testing. If metastasis exits, modified radical lateral lymph node dissection (LLND) was performed. For both groups, prophylactic central lymph node dissection was routinely done. Finally, the demographic information, tumor characteristics, postoperative pathological results, and laboratory data were collected for analysis. Results. A total of 61 CN0PTC were enrolled in this study, 33 in the CN group and 28 in the control group. The black-stained rate for CN was 29/40 (72.5%) with a positive prediction rate of 34.5%. The mainly black-stained region in the lateral neck was level III and possesses the highest lymph node ratio (17.5%). The metastasis that occurred in level VI was 30% and 11.8% in the CN and control groups, respectively ( p = 0.058 ). During the available follow-up, no one showed recurrence. Statistical analysis showed that the CN suspension can significantly reduce the risk of damage to the parathyroid gland ( p = 0.001 for hypocalcemia, <0.05; p = 0.047 for hypoparathyroidism, <0.05). Conclusion. The lateral neck metastasis in patients with papillary thyroid microcarcinoma in clinical stage cT1aN0 is not rare. CN can help surgeons to distinguish the real person who actually needs LLND. In prophylactic CLND, CN acts as a tracer which makes the parathyroid gland more identifiable and avoids risks of injuries to nerves and glands.

Potential Role of Carbon Nanoparticles in Guiding Central Neck Dissection and Protecting Parathyroid Glands in Patients with Papillary Thyroid Cancer

2019 ◽  
Vol 15 (3) ◽  
pp. 254-259
Author(s):  
Zhiliang Xu ◽  
Zhiyu Li ◽  
Qi Wu ◽  
Yimin Zhang ◽  
Shan Zhu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Dissection ◽  
Parathyroid Glands ◽  
Control Group ◽  
Papillary Thyroid ◽  
Node Dissection

Background: Carbon nanoparticle (CN) suspensions have been widely used as lymph node tracers in cancers. Here, CN suspension was successfully applied to lymph node dissection. Objective: This study aimed to evaluate the role of CN suspension in identifying lymph nodes and preserving the parathyroid in patients with papillary thyroid cancer (PTC). Method: A total of 96 PTC patients were divided into a CN group (n = 46) and a control group (n = 50). All patients underwent total thyroidectomy with central lymph node dissection from 2014 to 2015. Results: The number of lymph nodes removed in the CN group and the control group was 9.6±2.4 and 7.8±2.2, respectively, and the number of dissected lymph nodes identified as <5 mm in both groups was 4.4±1.3 and 2.4±1.4, respectively. These results were significantly different between the two groups (P < 0.05). However, the number of metastatic lymph nodes was similar in the two groups. In addition, the results further revealed that the level of serum parathyroid hormone (PTH) was significantly lower in the control group than in the CN group on postoperative day 1 and week 1 (P < 0.05), but similar outcomes were observed at postoperative month 1. Conclusion: CN suspension plays an important role in accurately identifying lymph nodes and protecting parathyroid glands. The clinical utilization of CN suspension could increase the accuracy of surgery programs and protect parathyroid function.

scholarly journals The role of carbon nanoparticle in lymph node detection and parathyroid gland protection during thyroidectomy for non-anaplastic thyroid carcinoma- a meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0223627
Author(s):  
Shaowei Xu ◽  
Zhifeng Li ◽  
Manbin Xu ◽  
Hanwei Peng
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Parathyroid Gland ◽  
Anaplastic Thyroid Carcinoma ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Significant Difference ◽  
Transient Hypoparathyroidism

Objective To assess the efficiency of the carbon nanoparticles (CNs) in lymph node identification and parathyroid gland (PG) protection during thyroidectomy for non-anaplastic thyroid carcinoma (N-ATC). Methods A systematic literature search for relevant literatures published up to December 2018 in PubMed, EMBASE, Web of Science and Cochrane Library was performed. Both English and Chinese literatures were retrieved and analyzed. Randomized controlled trials or nonrandomized controlled trials comparing the use of CNs with the use of methylene blue or a blank control in patients undergoing thyroidectomy for N-ATC were enrolled in this study. The primary outcomes included the number of lymph nodes harvested, the rate of lymph nodes involved, and the rates of accidental parathyroidectomy, hypoparathyroidism, and hypocalcemia. Weighted mean differences (WMDs), odds ratios (ORs) and risk differences (RDs) were calculated for the dichotomous outcome variables. Between study heterogeneity was tested using the Q tests and the I2 statistics. All analyses were performed using Review Manager (version 5.3.5). Results 25 studies comprising 3266 patients were included in this analysis. The total number of lymph nodes harvested in the CNs groups was significantly higher than that in the control groups (WMD, 2.36; 95% CI, 1.40 to 3.32; P <0.01). Administrating CNs was associated with a lower incidence of accidental PG removal (OR = 0.28, 95% CI = 0.21 to 0.37, P<0.01) and lower rates of both postoperative transient hypoparathyroidism (OR = 0.46, 95% CI = 0.33 to 0.64, P <0.01) and transient hypocalcemia (OR = 0.46, 95% CI = 0.33 to 0.65, P <0.01). No significant difference was found concerning lymph node metastatic rates between CNs group and control group. Subgroup analysis indicated that the application of CNs in reoperation thyroidectomy reduced both the rate of transient hypoparathyroidism (OR = 0.21, 95% CI = 0.06 to 0.75, P = 0.02) and the possibility of accidental PGs removal (OR = 0.21, 95% CI = 0.07 to 0.62, P = 0.004, P<0.05). Conclusions The application of CNs in thyroidectomy for N-ATC results in higher number of lymph node harvested and better PG protection during both initial and reoperation thyroidectomy.

scholarly journals The safety and effectiveness of carbon nanoparticles suspension in tracking lymph node metastases of colorectal cancer: a prospective randomized controlled trial

2020 ◽  
Vol 50 (5) ◽  
pp. 535-542 ◽  
Author(s):  
Renjie Wang ◽  
Shaobo Mo ◽  
Qi Liu ◽  
Wenming Zhang ◽  
Zhaozhen Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Carbon Nanoparticles ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Node Metastases ◽  
Nanoparticles Suspension

Abstract Objective This study was to evaluate the safety and effectiveness of carbon nanoparticles suspension in tracking lymph node metastases of colorectal cancer. Methods Eligible patients diagnosed with stages I–III colorectal cancer in Fudan University Shanghai Cancer Center between 1 May 2017 and 31 May 2018 fulfilling the inclusion criteria were included in this prospective randomized controlled study. All the patients were randomly allocated to two groups: the nanocarbon group and the control group. Patients’ clinicopathological characteristics were compared between the nanocarbon group and the control group. For continuous variables, data were presented as mean (±SD) and differences between the two groups were compared by the Mann–Whitney U test; for categorical variables, data was presented as frequency (%) and the Pearson’s chi-squared test was used to compare the differences between two groups. Results All the patients’ characteristics between two groups did not achieve statistical significance (P &gt; 0.05). Patients in nanocarbon group were more likely to be associated with more lymph nodes retrieved totally compared with control group (19.84 ± 6.428 vs. 17.41 ± 7.229, P &lt; 0.001). The number of lymph nodes retrieved in nanocarbon group were more likely to be ≥12 than that in the control group (P = 0.005). Conclusions Our study confirmed the safety of using carbon nanoparticles suspension as a tracer in colorectal cancer. More importantly, nanocarbon could significantly increase the detected number of lymph nodes in colorectal cancer, which can help improve the accuracy of lymph node staging and even improve patients’ survival.

scholarly journals Reassessing the Value of Contrast-Enhanced Ultrasonography in Differential Diagnosis of Cervical Tuberculous Lymphadenitis and Lymph Node Metastasis of Papillary Thyroid Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Xu Zhang ◽  
Lingling Wang ◽  
Na Feng ◽  
Tu Ni ◽  
Wei Tang
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Tuberculous Lymphadenitis ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Contrast Enhanced Ultrasonography

AimWe aimed to evaluate the ability of contrast-enhanced ultrasonography (CEUS) to perform differential diagnosis of cervical tuberculous lymphadenitis and lymph node metastasis from papillary thyroid cancer (PTC).MethodsWe analyzed 102 enlarged cervical lymph nodes as diagnosed by conventional ultrasound (US) and CEUS. The US and CEUS enhancement pattern and the time intensity curve (TIC) of the metastatic lymph nodes or tuberculous lymph nodes were compared following standard pathological protocols. The TIC included peak time (TTP), peak intensity (PI), and area under the gamma curve (AUC).ResultsPathological results demonstrated that 48 out of the 102 enlarged lymph nodes were lymph node metastasis from PTC, while 54 were tuberculous lymphadenitis. There was statistically significant differences in hyperechoic islands, pulse-like enhancement, and asynchronous enhancement between tuberculous lymphadenitis and lymph node metastasis (P &lt; 0.05), but their diagnostic sensitivity and specificity were unsatisfactory. In addition, our data did not show statistically significant difference in enhancement direction, enlarged range on CEUS, and perfusion defect (P &gt; 0.05). Similarly, quantitative parameters such as PI, TTP, and AUC did not yield significant differences between the groups.ConclusionTaken together, the present results demonstrate that CEUS can provide valuable information on lymph node blood flow, which can be used to identify tuberculous lymphadenitis and lymph node metastasis of PTC.

scholarly journals Expression of HIF-2αand VEGF in Cervical Squamous Cell Carcinoma and Its Clinical Significance

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Lixia Zhang ◽  
Qiang Chen ◽  
Jing Hu ◽  
Yue Chen ◽  
Chenglong Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinical Significance ◽  
Systemic Disease ◽  
Cervical Squamous Cell Carcinoma ◽  
Control Group ◽  
Vegf Mrna ◽  
Node Metastasis ◽  
Figo Staging ◽  
Vegf Mrna Expression

CSCC is a systemic disease involving polygenic alteration and multiple steps, and HIF and VEGF are closely associated with tumorigenesis. Specimens surgically resected from 64 cases of CSCC and 22 cases of normal cervical tissue were selected randomly to detect the expression of HIF-2αand VEGF in CSCC for exploring their clinical significance; information regarding the age, lymph node metastasis, and FIGO staging were collected as well; expression of HIF-2αand VEGF was detected by qPCR and immunohistochemistry. We found that the expression of HIF-2αand VEGF mRNA in CSCC was significantly higher than that of normal cervical tissues and showed a positive correlation between them. The positive rates of HIF-2αand VEGF protein expression in CSCC and normal cervical tissues were 93.8% and 18.2%, respectively, with correlation between them. The expression of both HIF-2αand VEGF mRNA did not relate closely to age but the FIGO staging and lymph node metastasis. Compared with the counterpart control group, CSCC tissues with high FIGO staging and lymph node metastasis had a higher level of HIF-2αand VEGF mRNA expression. So, HIF-2αand VEGF were overexpressed in CSCC, which has a great clinical significance for its diagnosis.

scholarly journals A preliminary study of bowel rest strategy in the management of Clostridioides difficile infection

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hiroshi Sugimoto ◽  
Ayaka Yoshihara ◽  
Takao Yamamoto ◽  
Keisuke Sugimoto
Keyword(s):  
Secondary Outcome ◽  
Control Group ◽  
Matched Cohort ◽  
Full Cohort ◽  
Clostridioides Difficile ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Clostridioides Difficile Infection ◽  
Bowel Rest ◽  
Preliminary Study

AbstractClostridioides difficile infection (CDI) is an important nosocomial infection and is the leading cause of infectious diarrhea in hospitalized patients. We aimed to assess the effect of bowel rest on the management of CDI. A single-center retrospective cohort study was conducted. The primary outcome was the composite of the all-cause mortality and CDI recurrence within 30 days. The main secondary outcome was switching from metronidazole to vancomycin. Of the 91 patients with CDI enrolled as the full cohort, 63 patients (69%) and 28 patients (31%) constituted the control group and the bowel rest group, respectively. After one-to-one propensity score matching, a total of 46 patients were included as the matched cohort. In the full cohort, the composite outcome occurred in 19.0% and 14.3% of the patients in the control and the bowel rest group, respectively (p = 0.768). In the matched cohort, it was 17.4% in each group. Although there was no statistically significant difference, the trend of switching was lower in the bowel rest group. The bowel rest may not affect the all-cause mortality and CDI recurrence within 30 days. However, in those prescribed bowel rest, switching from metronidazole to vancomycin may reduce.

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