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).
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Figure1. Labeling of fluorescent microspheres