Objective  To assess the usefulness of immune colloidal gold test strip for the rapid recognition of the parathyroid gland during surgery.

  Methods  This prospective study was performed from September 2017 to December 2018 in the Department of Head and Neck Surgery, Yunnan Cancer Hospital. During this period, 130 patients underwent thyroidectomy; of them, we randomly assigned 74 to the experimental group (immune colloidal gold test strip method) and 56 to control group 2 (conventional visual observation). Furthermore, we included 50 patients who underwent total thyroidectomy by the same team of doctors from January 2015 to January 2016 in control group 1. In control group 1, carbon nanotechnology was used to detect the parathyroid glands. Frozen pathological examination results and pre-and postoperative blood calcium and parathyroid hormone (PTH) levels were compared. All operations were performed by the same team of doctors.

  Results  There were 49 cases of pathologically confirmed parathyroid glands, and among them, 47 had PTH levels > 65 pg/mL (range, 62.1 to 1340.6 pg/mL) and the other 2 had PTH levels < 65 pg/mL. Another 41 cases without parathyroid gland detection had PTH levels < 65 pg/mL (P < 0.001). The difference was statistically significant. The true positive rate (sensitivity) of the immune colloidal gold test strip method in detecting the parathyroid gland was 97.4%, the false positive rate (misdiagnosis) was 0, and the accuracy was 98.3%. To compare the immune colloidal gold test strip method with carbon nanotechnology, we examined blood calcium and blood PTH levels on the first day after surgery (calcium, 2.073±0.167 vs. 2.043 ±0.167; PTH value, 35.767±13.159 vs. 34.570±11.620). The immune colloidal gold test strip method was superior to carbon nanotechnology (P>0.05), although the difference was not statistically significant. To compare the immune colloidal gold test strip method with conventional visual observation, we examined blood calcium and blood PTH levels on the first day after surgery (calcium, 2.073±0.167 vs. 1.982±0.234; PTH, 35.767±13.159 vs. 26.145±11.515). The values were much higher for the immune colloidal gold test strip method than for conventional visual observation (P < 0.05), although the difference was statistically significant.

  Conclusions  The immune colloidal gold test strip method can efficiently and quickly recognize the parathyroid glands during surgery. This ability allows us to maintain the position of the parathyroid glands, avoid their accidental removal, and examine the excised specimen. Parathyroid gland identification enables early transplantation, shortens operation time, and reduces surgical invasiveness.