关键词: 甲状腺肿瘤, 乳头状癌, 纳米颗粒, 颈淋巴清扫

Abstract: Objective Current studies generally support that intraoperatively injecting carbon nanoparticle（CNP） not only preserves parathyroid function but also improves neck dissection for cN0 stage papillary thyroid carcinoma（PTC）. However, impact of using CNP for cN1b stage PTC is still unknown. This study explored utility of CNP during therapeutic neck dissection and evaluation of oncology outcomes. Methods From Jan. 2017 to Jun. 2019, 142 consecutive cN1b PTC patients from the University of Hong Kong Shenzhen Hospital were recruited. All the patients underwent total thyroidectomy and compartmental neck dissection. Seventy-seven were injected CNP intraoperatively（CNP group） while 65 were operated without CNP（control group）. Study endpoints included number of total and metastatic lateral lymph node, postoperative stimulated thyroglobulin（Tg） before radioactive iodine（RAI） ablation, non-stimulated Tg after RAI, postoperative parathyroid hormone（PTH）,calcium. Results Demographics and operative time were comparable between the two groups. There was no significance for number of both total and metastatic lateral lymph node retrieved（22.13±9.95 vs. 21.10±10.69,P=0.583 and 4.29±3.12 vs. 3.96±3.69,P=0.574, respectively）. However, postoperative stimulated Tg was significantly higher in CNP group（2.59 ng/mL vs. 0.67 ng/mL, P=0.046）, while there was no significance for post-RAI suppressed Tg between the two groups（0.1 ng/mL vs. 0.1 ng/mL, P=0.205）. Postoperative Day 1 PTH was significantly lower in CNP group（8.1 pmol/L vs. 13.6 pmol/L, P=0.044）. Morbidity of post 6 month hypoparathyroidism has no significance between two groups. Conclusion Intraoperative injecting CNP may not facilitate lateral neck dissection and postoperative Tg level for cN1b PTC. Conversely, it has potential harm to postoperative short-term parathyroid function. Using CNP should be taken into consideration cautiously for cN1b PTC.

Key words: thyroid neoplasms, carcinoma, papillary, nanoparticle, neck dissection