Abstract:
Objective To explore the value of nanoparticles (CN) in lateral cervical lymph node mapping in papillary thyroid carcinoma using carbon.
Methods Thyroid cancer patients with suspicious lymph node metastasis but without typical signs of metastatic disease from March 2016 to November 2017 in Fudan University Shanghai Cancer Center were prospectively included in the cohort. Neck dissection was performed in all patients (compartments Ⅱ-Ⅴ). Suspicious lateral lymph node metastasis was identified using pre-operative ultrasound or computed tomography. CN were used for lymph node mapping during surgery.
Results A total of 70 surgeries were performed in 67 patients, among which 57 were found to have lateral lymph node metastasis (81.4%). The median number of CN-dyed lateral lymph nodes was 6. Compartment Ⅳ had the highest number of CN-dyed positive lymph nodes as well as the highest rate of metastasis, followed by compartment Ⅲ. In compartments Ⅲ and Ⅳ, the incidence of lymph node metastasis was significantly higher in the CN-dyed group than in the CN-undyed group (P < 0.001). When the final pathology of neck dissection was set as the gold standard, lateral CN-dyed lymph node biopsy was found to have a sensitivity of 86.0%; its negative predictive value was 61.9% and its overall accuracy was 88.6%.
Conclusions Injection of CN during surgery was a potential method of mapping lateral lymph nodes in papillary thyroid carcinoma. Compartment Ⅲ- Ⅳ CN-dyed lymph node biopsy had a satisfactory sensitivity and thus, served as a reasonable range for lymph node biopsy.
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