The coincidence rate of positive thyroid tissue and negative non-thyroid tissue was 100% using the Tg-POCT test reagent. Tg-POCT test reagent can be used to distinguish tissues that can normally secrete Tg from those that cannot.
Discussion
Thyroid cancer is a common endocrine malignant tumor, accounting for approximately 1% of all malignant tumors [4]. The incidence of thyroid cancer in the Chinese population is 1/300,000–1/200,000, with an annual increase of nearly 5 times since the last 10 years. More than 85% of thyroid cancers are thyroid papillary carcinomas[5]. Lymph node metastasis can occur in the early stage of PTC, but patients can still survive in the long term, provided that treatment is prompt and accurate. For patients with cervical lymph node metastasis, total thyroidectomy and regional lymph node dissection are generally required, after which thyroxine is administered, and I131nuclide ablation is required for high-risk patients. Generally, 5%-20% in situ or local recurrence and 10%-15% distal metastasis will occur after surgery[6-8].Therefore, accurate preoperative identification of the nature of thyroid mass and cervical lymph nodes is crucial for the selection of reasonable surgical methods and treatment programs; in addition, rapid intraoperative identification of the nature of cervical metastatic lymph nodes is particularly important for favorable prognosis of thyroid tumor patients.
At present, the diagnostic methods for suspected cervical metastatic lymph nodes of thyroid cancer mainly include high-frequency ultrasound (B ultrasound), neck CT, fine needle aspiration biopsy cytology (FNAC), and other examination methods. Among them, b-mode ultrasound is a convenient and harmless examination method, which can assist in the identification of benign and malignant thyroid nodules, but its main disadvantages are that it cannot reflect the histological characteristics of nodules and that b-mode ultrasound examination is relies heavily on the experience of the examiner, thus being subjective to some extent. The diagnostic value of neck CT for thyroid nodule lesions is not well reported in the literature and is rarely used in the clinical setting. B-ultrasound guided FNAC is currently recognized as the most direct method to identify the nature of the mass and lymph node. It has been reported that the sensitivity and specificity can reach 87% and 76%, respectively, but 20%–40% of puncture specimens cannot be accurately identified, and cytological examination results are quite influenced by the experience of the technician[9-10]. The above diagnostic methods are mainly used for preoperative identification and prognosis, but these cannot be used intraoperatively due to the need for large instruments or the prolonged examination time.
Traditional methods for Tg detection mainly include radioimmunity, enzyme-linked immunoassay, and chemiluminescent immunoassay, but these methods require large instruments and require a long detection time, which are not suitable for rapid intraoperative detection. Fluorescence microsphere immunochromatography is a novel, innovative quantitative detection technology developed by combining time-resolved fluorescence immunoassay and traditional immunochromatography. It has the characteristics of high sensitivity, good stability [11], and short detection time.
Conclusions
In this study, a rapid intraoperative detection method for Tg was developed, which is characterized by good stability, high sensitivity, and high specificity. Combined with intraoperative fine needle puncture, it can quickly help to detect thyroid cancer metastasis in the lymph nodes, which will help to improve the efficiency and quality of surgical treatment.
Conflicts of interest
There are no conflicts to declare.
Acknowledgements
This work was supported by the Innovation Capacity Development Plan of Jiangsu Province (BM2018023-2), Jiangsu Provincial Key Medical Discipline (Laboratory)(ZDXKA2016017), the Technology Research Program of Shiyan City(19Y86), Medical and Public Health Project of Wuxi Sci-Tech Development Fund (No WX18ⅡAN047) and AD7C-NTP in alzheimer’s disease of Wuxi area(MS201803).
Notes and references
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Figure1. Labeling of fluorescent microspheres