Potential role of carbon nanoparticles in protection of parathyroid glands in patients with papillary thyroid cancer

Abstract

As a novel type of lymphatic tracer, carbon nanoparticles (CNs) were reported not to stain parathyroid glands (PGs) into black, so it may have a clinical potential in protection of PGs during thyroidectomy. The purpose of this study was to investigate the clinical application and significance of CN in protection of PGs from surrounding tissues.A total of 82 consecutive patients were enrolled into this study and were divided into CN group and control group. Parathyroid function (hypoparathyroidism and hypocalcemia) was evaluated.The identification rates of PGs (≤2) and PGs (≥3) were 24.4% and 75.6% in the CN group and 46.3% and 53.7% in the control group, respectively. The difference in the identification rates between the 2 groups was statistically significant (P = 0.038). Pathological results revealed 3 accidental PGs resection occurred in the CN group, whereas 9 accidental PGs removal occurred in the control group. The difference was statistically significant (P = 0.046). Moreover, the incidence of the patients with hypoparathyroidism was statistically significant between the 2 groups (36.6% in CN group vs 53.7% in control group, P = 0.043) at day 1, but not at day 7 (P = 0.424).CN may have a potential in protecting PGs clinically.

Diagnosis and treatment of hypoparathyroidism: a position statement from the Brazilian Society of Endocrinology and Metabolism

“…There have been recent attempts at the development of auxiliary methods to identify the parathyroid glands during thyroidectomy, such as the injection of nanoparticles of carbon into the thyroid (59,60) and detection of the natural autofluorescence of the parathyroid with near-infrared imaging (61)(62)(63) or in association with methylene blue (64) or indocyanine green (65). In spite of these techniques improving the identification of the parathyroids, they have been unable to reduce the rates of hypoparathyroidism after total thyroidectomy (B) (66).…”

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

“…Carbon nanoparticles (CN), approved by China Food and Drug Administration, have been well applied to assist lymph node dissection for gastric cancer, breast cancer and etc(7, 8). In the recent years, CN is used as a novel surgical technology for tracer of lymph nodes and localization of parathyroid during thyroid cancer surgery(21). So far, No toxic side effects have been reported in humans.…”

“…So far, No toxic side effects have been reported in humans. However, when the CNs was injected improperly and they spread out of the thyroid capsule, it may stain the surgical field, which makes surgical procedure more difficult(21). In most of the included studies, the dose of CNs is 0.1 to 0.2 ml per point and two to three points around tumor within the thyroid capsule were recommended.…”

Conditioning neoadjuvant therapies for improved immunotherapy of cancer

“…In humans, carbon nanoparticles have been successfully used to protect parathyroid glands in patients with thyroid cancer. Such a nanotechnology approach reduced incidence of hypoparathyroidism and hypocalcemia after surgical removal of thyroid tumor [86]. Safety and efficacy of SGT-53 liposomal nanoparticle delivery of p53 gene into refractory solid tumors in combination with chemotherapy have also been established [87].…”