Intra-operative Rapid Identification of Lymph Node and Parathyroid
Intra-operative Rapid Identification of Lymph Node and Parathyroid
During surgery, a fine needle puncture was proceeded when suspicious nodes was found by
 clinician. Repeat the punction for 2-3 times from different orientation and then, Diff-quik
 staining or PTH immunochromatographic assay were proceeded for lymph node or parathyroid
 glands identification. Post-operative pathology outcome was considered as golden standard.
In the experiment group, when suspicious parathyroid glands or lymph nodes were observed, a
 22 G needle was applied for in situ puncture at a 45 degree angle. The needle was initially
 thrust into the gland for 0.2 mm, and then we advanced the needle for another 0.2mm while
 gently withdrawing the plunger of the syringe and maintaining negative pressure. At this
 point, there has parathyroid tissue been adsorbed in the needle. Repeat this process in two
 different directions to guarantee the simple volume.

 When cell smears finished, the smears were fixed in stationary liquid within 2-4 seconds for
 5-20 seconds, and then Diff-Quik (DQ) staining technique was proceeded for rapid
 identification using Diff-Quik staining kit according to the instruction. After the following
 Diff-quick staining for 30 seconds, we can make out parathyroid cells and lymph nodes under
 high power microscope.

 In addition,PTH immunochromatographic assay kit can also be used for parathyroid glands
 detection. Using indicator paper to dip to the punctured tissue, the existance of parathyroid
 glands could be ensured.

 HE (Hematoxylin and Eosin) staining was used for pathological verification of suspicious
 nodes found during surgery. The suspicious nodes occurred in surgery were isolated and fixed
 with 4% paraformaldehyde for 12 h, embedded in parafﬁn and cut into 3-µm serial sections.
 Corresponding sections were stained with hematoxylin (BASO Diagnostics Inc. Zhuhai) for 10
 min at room temperature. Then, sections were washed with running water. Subsequently,
 sections were washed with Scott promote blue liquid for 1 min, 1% hydrochloric acid alcohol
 differentiation liquid for 20 s, and Scott promote blue liquid for 1 min. Then, sections were
 stained with eosin (BASO Diagnostics Inc. Zhuhai) for 30 s. Sections were washed with running
 water and sealed for observation. Finally, sections were observed by Image-Pro Plus 5.0
 software (Media Cybernetics, Inc., Bethesda, MD, USA).
Inclusion Criteria:

 - Thyroid cancer patients undergoing thyroid cancer surgery Preoperative examination were
 all ready for surgery Diagnosed with thyroid cancer by fine needle puncture before surgery

 Exclusion Criteria:

 - Patients enrolled into another clinical study Pregnant patients Patients diagnosed with
 another life-treating disease Patients with surgical contraindication