Oddi sphincter preserved cholangioplasty with hepatico-subcutaneous stoma for hepatolithiasis.

AIM: To evaluate the long-term outcomes of Oddi sphincter preserved cholangioplasty with hepatico-subcutaneous stoma (OSPCHS) and risk factors for recurrence in hepatolithiasis. METHODS: From March 1993 to December 2012, 202 consecutive patients with hepatolithiasis underwent OSPCHS at our department. The Oddi sphincter preserved procedure consisted of common hepatic duct exploration, stone extraction, hilar bile duct plasty, establishment of subcutaneous stoma to the bile duct. Patients with recurrent stones can undergo stone extraction and/or biliary drainage via the subcutaneous stoma which can be incised under local anesthesia. The long-term results were reviewed. Cox regression model was employed to analyze the risk factors for stone recurrence. RESULTS: Ninety-seven (48.0%) OSPCHS patients underwent hepatic resection concomitantly. The rate of surgical complications was 10.4%. There was no perioperative death. The immediate stone clearance rate was 72.8%. Postoperative cholangioscopic lithotomy raised the clearance rate to 97.0%. With a median follow-up period of 78.5 mo (range: 2-233 mo), 24.8% of patients had recurrent stones, 2.5% had late development of cholangiocarcinoma, and the mortality rate was 5.4%. Removal of recurrent stones and/or drainage of inflammatory bile via subcutaneous stoma were conducted in 44 (21.8%) patients. The clearance rate of recurrent stones was 84.0% after subsequent choledochoscopic lithotripsy via subcutaneous stoma. Cox regression analysis showed that residual stone was an independent prognostic factor for stone recurrence. CONCLUSION: In selected patients with hepatolithiasis, OSPCHS achieves excellent long-term outcomes, and residual stone is an independent prognostic factor for stone recurrence.

Laparoscopic hepaticoplasty using gallbladder as a subcutaneous tunnel for hepatolithiasis.

AIM: To investigate the feasibility, efficacy and safety of laparoscopic hepaticoplasty using gallbladder as subcutaneous tunnel and sphincter-of-Oddi preservation for hepatolithiasis. METHODS: From January 2010 to July 2013, six patients with hepatolithiasis were treated at our institution. All the patients underwent laparoscopic surgery. The procedures included common hepatic duct exploration, stone clearance by fiberoptic choledochoscopy, hilar bile duct hepaticoplasty with preservation of the sphincter of Oddi, anastomosis between the hilar bile duct and neck of the gallbladder, and establishment of a subcutaneous tunnel with the gallbladder. Two patients underwent left lateral hepatectomy simultaneously. Clinical data including operation time, intraoperative blood loss, operative morbidity, hospital mortality, stone clearance, and recurrence rate were analyzed. RESULTS: All patients successfully completed laparoscopic surgery. The mean length of hospital stay was 4.5 ± 0.9 d (range: 3-6 d). The mean blood loss of the hepatectomy was 450 mL (range: 200-700 mL), and the blood loss of the other four was 137 ± 151 mL (range: 50-400 mL). The mean operative time was 318 ± 68 min (range: 236-450 min). The operative morbidity and hospital mortality were zero. The immediate stone clearance rate was 100%. All patients were followed up for an average of 17 mo (range: 7-36 mo). One of the six patients had abdominal mass with pain, and subcutaneous tunnel cholangiography showed severe gallbladder-biliary anastomotic stricture at 4 mo postoperatively. There was no stone recurrence and no cholangitis during follow-up. CONCLUSION: Laparoscopic hepaticoplasty using gallbladder with a subcutaneous tunnel and preserving the sphincter of Oddi is feasible, safe and effective for hepatholithiasis.

[Treatment of hepatolithiasis by multiple operative methods with hepatico-subcutaneous stoma].

OBJECTIVE: To evaluate the mid-term and long-term outcomes of patients with hepatolithiasis after receiving multiple operative methods with hepatico-subcutaneous stoma. METHODS: A retrospective analysis was performed based on 156 patients with hepatolithiasis who underwent multiple operative methods with hepatico-subcutaneous stoma from Apr. 1993 to Mar. 2010 in Peking University Third Hospital. Thirty-seven of them had stone in the left lobe (23.7%), 22 in the right lobe (14.1%), and 97 in bilateral lobes (62.2%). Ninety-nine patients had hepatolithiasis combined with biliary stricture (63.5%). RESULTS: All of the patients underwent successful operations and recovered well with no death in perioperative period. The rate of operative complications was 35.9%. A total of 146 patients were followed up with a median time of 7 years. The rate of patients with cholangitis, recurrent stone, and biliary stricture newly detected was 13.0% (19/146), 21.9% (32/146) and 8.2% (12/146), respectively. Draining inflammatory bile and taking out recurrent stones by hepatico-subcutaneous stoma were carried out in 35 patients (24.0%). CONCLUSION: Treatment of hepatolithiasis with biliary stricture and its recurrence by multiple operative methods with hepatico-subcutaneous stoma is safe, effective, minimally invasive, and easy to perform.

An end-to-end anastomosis model of guinea pig bile duct: A 6-mo observation.

AIM: To establish the end-to-end anastomosis (EEA) model of guinea pig bile duct and evaluate the healing process of bile duct. METHODS: Thirty-two male guinea pigs were randomly divided into control group, 2-, 3-, and 6-mo groups after establishment of EEA model. Histological, immunohistochemical and serologic tests as well as measurement of bile contents were performed. The bile duct diameter and the diameter ratio (DR) were measured to assess the formation of relative stricture. RESULTS: Acute and chronic inflammatory reactions occurred throughout the healing process of bile duct. Serology test and bile content measurement showed no formation of persistent stricture in 6-mo group. The DR revealed a transient formation of relative stricture in 2-mo group in comparation to control group (2.94 ± 0.17 vs 1.89 ± 0.27, P = 0.004). However, this relative stricture was released in 6-mo group (2.14 ± 0.18, P = 0.440). CONCLUSION: A simple and reliable EEA model of guinea pig bile duct can be established with a good reproducibility and a satisfactory survival rate.

Long-term outcomes of choledochoduodenostomy for hepatolithiasis.

BACKGROUND: Oddi sphincter plays an important role in preventing reflux cholangitis. There exists the controversy on application of choledochoduodenostomy in hepatolithiasis management. The present study aimed at evaluating long-term outcomes of choledochoduodenostomy for the treatment of hepatolithiasis. METHODS: Forty-six consecutive cases of hepatolithiasis who underwent choledochoduodenostomy were analyzed retrospectively. The pre- and postoperative rates of recurrent cholangitis and acute cholangitis severe type were compared. Paired chi-square test was applied. RESULTS: The mean follow-up time was 17.3 years ranging from 1.6 to 40 years with a follow-up rate of 97.8% (45/46). High rates of remnant stones (39.1%, 18/46), recurrent stones (31.1%, 14/45), uncorrected strictures (85%, 17/20), and mortality (24.4%, 11/45) were observed in this group. Regurgitation of food debris and duodenal content into the biliary tract through the anastomosis was observed. The rate of recurrent cholangitis was equal to the preoperative period (93.3%, 42/45). The rate of acute cholangitis severe type after choledochoduodenostomy (46.7%, 21/45) increased significantly (P<0.01) when compared to the preoperative period (20.0%, 9/45). CONCLUSIONS: Choledochoduodenostomy did not entirely achieve the goal of clearance of stones, correction of strictures, and removing of hepatobiliary lesions by itself. Choledochoduodenostomy without cholangioplasty resulted in an increase of severe reflux cholangitis due to the loss of the anti-reflux function of the sphincter of Oddi. Therefore, choledochoduodenostomy is not an ideal approach to reduce cholangitis in hepatolithiasis and is not the best choice in the management of hepatolithiasis.

[Fourier transform infrared spectroscopic study on gallbladder carcinoma].

Fourier transform infrared (FTIR) spectroscopy with an attenuated total reflection(ATR) probe was used to study the benign and malignant tissues of gallbladder. FTIR spectra of 18 tissues of gallbladder carcinoma and 139 benign tissues were collected and analyzed. The results demonstrated that bands related to lipid, carbohydrate, and nucleic acid from malignant samples were significantly different from those of benign ones: (1) The peak positions of 1 167 and 1 123 cm(-1) shifted toward lower wave number (P < 0.05) but that of 1 309 cm(-1)' to the higher one (P < 0.05); (2) The relative intensity ratios of I2 856/I1 461, I1 167/ I1 461, I1 123/I1 461, I1 082/I1 461, increased significantly (P < 0.05) (3) The half-widths of 1 167 and 1 082 cm(-1) increased significantly (P < 0.05), whereas the half-width of 1 461 cm(-1) decreased significantly (P < 0.05). (4) The probability of 1 750 cm(-1) band of gallbladder carcinoma tissues increased significantly (P < 0.05).

(E)-N'-(3-Nitro-benzyl-idene)-4-(8-quinol-yloxy)butano-hydrazide.

In the title Schiff base compound, C(20)H(18)N(4)O(4), the conformation along the bond sequence linking the benzene and quinoline rings is trans-(+)gauche-trans-trans-(+)gauche-trans-trans. The dihedral angle between the aromatic ring systems is 80.3 (6)°. In the crystal, a pair of inter-molecular N-H⋯N hydrogen bonds link the mol-ecules into centrosymmetric R(2) (2)(20) dimers, which are aggregated via π-π inter-actions into sheets [quinoline-benzene ring centroid-centroid separation = 3.572 (2)-3.773 (3) Å].

[Investigation on Fourier transform infrared spectrum of freshly resected cholangiocarcinoma tissue].

To explore the feasibility of quick intraoperative in situ and noninvasive diagnosis of cholangiocarcinoma by Fourier transform infrared (FTIR) spectroscopy, 26 samples of freshly resected cholangiocarcinoma tissues and 43 samples of benign bile duct tissue were collected during surgery. And all fresh samples were measured by FTIR spectroscopy via probe of attenuated total reflection (ATR) without pretreatment immediately after resection. For each spectrum, 12 bands were identified and assigned between 3 800 and 1 000 cm(-1). The peak position was found, and the intensity and area of the bands were measured; The ratios of the intensity and area were calculated. Standard statistic analysis was performed. The results illustrated that the FTIR spectra of malignant tissue were significantly different from those of benign tissue: 1. The bands related to lipid: The peak of 2 925 cm(-1) shifted to lower wave number significantly (P = 0.033); 2. The bands related to nucleic acid and lipids: the ratios of I1 083/ I1 460 (P = 0.005), S1 083 /S1 460 (P = 0.001) and S1 240/S1 460 (P = 0.025) raised significantly, indicating that the relative quantity of nucleic acid to lipids had evidently increased in malignancy. 3. The bands related to protein: The ratios of I1 550/I1 083 (P = 0.000) and S1 550/S1 083 (P = 0.000) reduced significantly, implying that the relative quantity of protein to nucleic acid in malignancy decreased significantly and the secondary structure of protein changed probably. Our primary result illustrated that the FTIR spectroscopy technique maybe a promising method for in situ and quick intraoperative diagnosis of cholangiocarcinoma and has great value for clinical application.

[Investigation on Fourier transform infrared spectrum of metastatic lymph node in thyroid cancer].

The aim of the study is to explore the possibility of detecting metastatic lymph nodes by FTIR spectra during the surgery of thyroid cancer. The FTIR spectra of 20 metastatic lymph nodes and 69 non-metastatic ones were collected via an ATR (attenuated total reflectance) probe. For each spectrum, 28 variables of 13 bands including peak positions and relative intensities were measured. The variables of metastatic lymph node were compared to those of non-metastatic ones using standard statistic methods. The results indicated that the FTIR spectra of metastatic lymph nodes were significantly different from non-metastatic ones in the bands related to protein, lipid, nucleic acid and carbohydrate. (1) Variations of bands related to protein: The relative intensity ratios of I3 280 /I1 460, I1 640 /I1 460 and I1 546/I1 460 increased significantly (P < 0.05); (2) Variations of bands related to lipid: The relative intensity ratios of I1 743 /I1 460 decreased significantly (P < 0.05). On the contrary, I 400 /I1 460 increased significantly (P < 0.05); (3) The peak positions of 1 165 and 1 120 cm(-1) which were all assigned to carbohydrate shifted toward higher wave number (P < 0.05). The relative intensity ratio of I1 165 /I1 460 decreased significantly (P < 0.05); (4) The peak positions of 1 085 cm(-1) related to nucleic acid shifted to the lower wave number (P < 0.05); (5) Other undetermined bands: The relative intensity ratios of I1 303 /I1 460 and I1 303 /I1 240 increased significantly (P < 0.05). FTIR spectroscopy could be a reliable and practicable method for metastatic lymph nodes diagnosis in the operation of thyroid cancer. It could be applied in detecting metastatic lymph nodes which can not be determined by palpation in surgery.

[Surface detection of thyroid cancer by Fourier transform infrared spectroscopy].

OBJECTIVE: To explore a novel non-invasive method in detection of thyroid cancer by Fourier transform infrared (FTIR) spectroscopy. METHODS: Surface FTIR spectra of 15 cases of thyroid cancer and 51 cases of normal subjects were collected. 22 variables of 11 bands including peak positions and relative intensities were measured and all data were statistically analyzed. RESULTS: In the cancer group: (1) the peak position of 1743 cm(-1) was shifted toward higher wave number (P < 0.05), and that of 1250 cm(-1) to the lower (P < 0.05), when compared to those of normal ones. (2) The relative intensity ratios of I(1546)/I(1460), I(1250)/I(1460), I(1120)/I(1460), I(1080)/I(1460) were significantly increased (P < 0.05). (3) The presence rate of band of 1340 cm(-1) was significantly decreased (P < 0.05). CONCLUSION: FTIR surface spectra may become a novel powerful non-invasive approach of detecting thyroid cancer in regular routine check-up.

[Clinical effects of subcutaneous tunnel hepatocholangioplasty on the treatment of hepatolithiasis].

OBJECTIVE: To evaluate the therapeutic effect of subcutaneous tunnel hepaticoplasty on the treatment of hepatolithiasis. METHODS: The early complications and clinical effects of 99 hepatolithiasis cases who underwent subcutaneous tunnel hepaticoplasty from January 1993 to August 2006 were analyzed retrospectively. The stones of 28 (28.3%) patients were in the left lobe, 24.2% (24/99) in the right, and 47.5% (47/99) in bilateral lobe. Sixty-six patients (66.7%) had both stones and biliary strictures. During the procedure, a portion of the liver habouring stone was resected if necessary. The hepatic duct and strictures were opened, the stones were removed, and the porta hepatis was repaired by one end of a segment of jejunum. The other end of the jejunum was set subcutaneously. The gall bladders of 27 patients (27.3%) were used as subcutaneous tunnel instead. RESULTS: Ninety-five out of ninety-nine cases were followed up with an average of 4.2 years (1 month to 13.5 years). The rates of residual stone, recurrent stone and cholangitis were 23.2% (23/99), 20.0% (19/95) and 14.7% (14/95) respectively. Postoperatively, 34 cases who had residual or recurrent stones were underwent lithotomy by choledochoscope through the subcutaneous blind loop and the achievement ratio was 91.2% (31/34). CONCLUSIONS: Subcutaneous tunnel hepatocholangioplasty decreases the relapsing cholangitis effectively, and makes an easy way to take out residual or recurrent stones.

Can pigment gallstones be induced by biliary stricture and prevented by medicine in Guinea pigs?

AIM: To determine the relationship between biliary stricture and pigment gallstone formation, and the prevention of pigment gallstones with medicine. METHODS: One hundred and eighteen male guinea pigs were randomly divided into four groups: stricture group (S, n = 30) underwent partial ligation of common bile duct, and fed on regular chow; S plus medicine group (S+M, n = 27) underwent the same operation but fed on medicinal chow (0.3 g chenodeoxycholic acid, 0.5 g glucurolactone, and 0.5 g aspirin were mixed up in 1.2 kg regular chow); medicinal control group (C+M, n = 30) was free of operation, and fed on medicinal chow; and control group (C, n = 31) was free of operation and fed on regular chow. One week later, laparotomy was performed, and the bile of gallbladder was collected, measured, and cultured. RESULTS: Gallstones were identified. Pigment gallstones were induced by biliary stricture in 95% (22/23) of S group. In the S+M group, the incidence of gallstone was reduced to 55% (11/20, vs S group, P < 0.01). The changes of indirect bilirubin and ionized calcium in the bile were consistent with gallstone incidences. CONCLUSION: Biliary stricture can cause pigment gallstone formation in guinea pigs, and the medicines used can lower the incidence of gallstones. The bilirubin and ionized calcium play important roles in pigment gallstone formation.

[Application of KNN method to cancer diagnosis using Fourier-transform infrared spectroscopy].

Early diagnosis and early medical treatments are the keys to save the patients' lives and improve their living quality. Fourier transform infrared (FTIR) spectroscopy can be used to distinguish malignant from normal tissues at the molecular level. In the present paper, programs were made with chemometrics method of pattern recognition to classify unknown tissue samples. Spectral data were pretreated by using smoothing, SNV and RHM method. Cross validation was used to test the discrimination effect of KNN method. A total of 63 gastric tissue samples were employed in this study, including 26 cases of normal tissue samples and 37 cases of cancerous tissue samples. The recognition results of the KNN method showed that the correctness of classification achieved 91.7%.

[FTIR spectroscopic explorations of freshly resected thyroid malignant tissues].

In the present paper, 17 cases of freshly resected malignant thyroid tissue samples and 23 cases of benign thyroid tissue samples were characterized using FTIR spectroscopy with an ATR probe. Statistic analysis indicated that the FTIR spectra of cancerous tissue were significantly different from those of benign tissue. In comparison with normal tissues, the FTIR spectra of malignant thyroid tissues possess the following features: (1) Variation of bands related to protein: Amide I band shifted to lower wave number significantly (P<0.01), while amide II band shifted to higher wave number(P<0.05), and the ratios of I1640/I1460 and I1640/I1550 were raised (P<0.01). The authors can conclude that the amounts and the secondary structure of protein in malignant tissue changed. (2) The peaks at 2955, 2920, 2870, 2850 and 1740 cm(-1) appeared less frequently suggesting that the relative quantity of lipid in malignant tissue decreased significantly; (3) Variation of bands related to nucleic acid: The band of 1241 cm(-1) shifted to (1238.29+/-2.87)cm(-1), and the ratios of I1080/I1460 were raised significantly(P<0.05). The most possible reason for the changes was that the mutation of DNA and the amounts of nucleic acid had increased in malignant neoplasms. Experimental results show that the malignant thyroid tissues can be distinguished from the benign tissues by their infrared spectra. This approach proves that FTIR spectroscopy is a reliable and practicable method for thyroid cancer diagnosis in operations. The authors have expanded their research on detecting the thyroid cancer FTIR spectra via percutaneous and in vivo, and have achieved a positive result which is going to be reported in another paper.

[FTIR spectroscopic characterization of freshly removed breast cancer tissues].

OBJECTIVE: To identify the FTIR spectroscopic characterization of breast cancer and explore the possibility of application of FTIR in differentiation of malignant and benign breast lesions. METHODS: FTIR spectra of surgically removed fresh breast tissues were measured by spectrometer equipped with mid-infrared fiber optics and an ATR probe. Peaks in the spectra were measured and relative intensity ratios were calculated and analyzed if there are significant differences between the spectra of malignant and benign breast lesions. RESULTS: There were significant differences (P < 0.05) between the spectra of malignant breast cancers and benign breast tissues in the relative intensity ratios of different peaks (I1640/ I1550 and I1160/I1120 for protein structures; I1640/I1460 and I1550/I1460 for relative content of protein and lipid; I1460/I1400 for lipid structures; I1310/I1240 for nucleic acid). CONCLUSION: FTIR spectroscopy could be a useful tool in clinical diagnosis of breast cancer.

Clinical application of plasma shock wave lithotripsy in treating impacted stones in the bile duct system.

AIM: To verify the safety and efficacy of plasma shock wave lithotripsy (PSWL) in fragmenting impacted stones in the bile duct system. METHODS: From September 1988 to April 2005, 67 patients (26 men and 41 women) with impacted stones underwent various biliary operations with tube (or T-tube) drainage. Remnant and impacted stones in the bile duct system found by cholangiography after the operation were fragmented by PSWL and choledochofiberscopy. A total of 201 impacted stones were fragmented by PSWL setting the voltage at 2.5-3.5 kV, and the energy output at 2-3 J for each pulse of PSWL. Then the fragmented stones were extracted by choledochofiberscopy. The safety and efficacy of PSWL were observed during and after the procedure. RESULTS: One hundred and ninety-nine of 201 impacted stones (99.0%) in the bile duct system were successfully fragmented using PSWL and extracted by choledochofiberscopy. The stone clearance rate for patients was 97% (65/67). Ten patients felt mild pain in the right upper quadrant of the abdomen, and could tolerate it well. Eleven patients had a small amount of bleeding from the mucosa of the bile duct. The bleeding was transient and stopped spontaneously within 2 min of normal saline irrigation. There were no significant complications during and after the procedure. CONCLUSION: PSWL is a safe and effective method for fragmenting impacted stones in the bile duct system.

[Prognostic analysis of T1 and T2 stage gallbladder cancer with invasion within the gallbladder wall].

OBJECTIVE: To explore the impact of different treatment procedure on the prognosis of T1 and T2 stage gallbladder cancer with the invasion within the gallbladder wall. METHODS: A retrospective analysis was conducted on 45 patients with pathologic stage T1 and T2 gallbladder cancer who had undergone surgical resection from 1990 and 2005. RESULTS: Depth of invasion (T), radical cholecystectomy and postoperative adjuvant chemotherapy were independent prognostic factors on Cox multivariate analysis. The 5-year survival rates of patients with T1a, T1b and T2 stage gallbladder cancer who underwent simple cholecystectomy without postoperative adjuvant chemotherapy were 100%, 67% and 0, respectively. The survival rate in T2 was significantly lower than those in T1a and T1b. Without postoperative adjuvant chemotherapy, the 5-year survival rates of patients with T2 stage gallbladder cancer who underwent simple cholecystectomy and radical cholecystectomy were 0 and 63%, respectively. There was significant difference between the survival time of T2 patients who had undergone simple cholecystectomy with and without postoperative adjuvant chemotherapy. CONCLUSIONS: The prognosis of patients with T1 stage gallbladder cancer is much better than that of T2 stage. The 5-year survival rates of patients with T1a and T1b stage gallbladder cancer who received simple cholecystectomy are relatively good. Radical cholecystectomy and postoperative adjuvant chemotherapy can improve the prognosis of patients with T2 gallbladder cancer.

[FTIR spectroscopic explorations of clinical practice of breast cancer].

The authors detected ten normal breast tissue samples and eight breast cancer samples by FTIR spectroscopy with an ATR probe. Nineteen variables of thirteen bands in the spectra were compared using standard statistic methods. The results demonstrated that bands of protein, lipid, carbohydrate, and nucleic acid from cancerous samples were significantly different from those from normal ones: (1) The relative intensity of N-H band increased and amide I band shifted to lower wave number significantly; (2) Symmetric and antisymmetric vibrations of -CH2 group, C=O vibration, and relative intensity of (-CH2)n decreased; (3) The intensity of 1160 cm(-1) band was much weaker than that of 1120 cm(-1); (4) The band of P=O or P-O-C shifted toward lower wave number. The authors believe that FTIR spectroscopy has a promising future in breast cancer diagnosis.

In vivo and in situ detection of colorectal cancer using Fourier transform infrared spectroscopy.

AIM: Real-time and rapid identification of the malignant tissue can be performed during or before surgical operation. Here we aimed to detect in vivo and in situ colorectal cancer by using Fourier transform infrared (FTIR) spectroscopy and fiber-optic technology. METHODS: A total of five patients with large intestine cancer were detected in vivo and in situ. Of them, three cases of colon cancer and one case of cecum cancer were detected intraoperatively and in vivo by using a FTIR spectrometer during surgical operation, and one case of rectum cancer was explored non-invasively and in vivo before the surgical operation. Normal and malignant colorectal tissues were detected in vivo and in situ using FTIR spectroscopy on the basis of fundamental studies. RESULTS: There were significant differences between FTIR spectra of normal and malignant colorectal tissues detected in vivo and in situ. Experimental results revealed that the spectral characteristics of normal and malignant tissues found in vivo and in situ were similar to those obtained from in vitro measurement in our previous fundamental research. CONCLUSION: FTIR fiber-optic attenuated total reflectance (ATR) spectroscopy can identify in situ and in vivo colorectal cancer. FTIR spectroscopic method with fiber optics is a non-invasive, rapid, accurate and in vivo cancer detection technique in clinical diagnosis.

[Nodular goiter surface detection by FTIR spectroscopy].

A novel non-invasive diagnosis method of nodular goiter is proposed in the present study by recording FTIR spectra on the skin overlying thyroids using fiber optical technique and attenuated total reflection probe. FTIR spectra from 20 nodular goiters and 34 normal controls were collected. Twenty seven spectral variables of 13 bands including peak position and relative intensities were extracted from the FTIR spectra so that statistic work could be conducted using SPSS. The results demonstrate that peak positions of 2 925 and 1 250 cm(-1) both shifted toward lower wave number (P < 0.05) in the FTIR spectra of nodular goiter. The relative intensity ratios of H1 740/H1 460, H1 160/H1 460, and H1 160/H1 120 decreased significantly in FTIR spectra of nodular goiter (P < 0.05). Inversely, H1 080/H1 460 increased significantly (P < 0.05) in nodular goiter. The above statistic differences suggest that nodular goiter may produce some characteristic chemical substance which can diffuse onto the surface of skin and therefore be detectable using FTIR spectroscopy with fiber optic techniques. These differences are the basis of diagnosing nodular goiter by FTIR surface detection.