Wiseman Sam M, Hicks Wesley L, Chu Quyen D, Rigual Nestor R
Department of Head and Neck Surgery, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Surg Oncol. 2002 Nov;11(3):137-42. doi: 10.1016/s0960-7404(02)00027-0.
Sentinel lymph node biopsy has recently been utilized to map tumor lymphatics in patients with differentiated thyroid carcinoma. Currently, controversy centers around the feasibility and future role of this technique in the management of differentiated thyroid cancer patients. A review of the current literature in which sentinel lymph node biopsy was performed on patients with a diagnosis of differentiated thyroid cancer was undertaken. Sentinel lymph node biopsy has been carried out on thyroid cancer patients utilizing a vital dye technique, a radiotracer technique, and a combination of both techniques. In the current literature the average rate of sentinel node identification is 91% (range 66-100%) and when identified, the sentinel node accurately predicts the disease status of the neck in most patients (range 80-100%). Limitations to carrying out the sentinel node biopsy on thyroid cancer patients include staining of parathyroid glands, identification of lymph nodes draining into the mediastinum, and the 'shine through' effect. Sentinel lymph node biopsy is technically feasible, but for a disease in which nodal metastases are of debatable prognostic value, the clinical utility of sentinel lymph node biopsy in the management of patients with differentiated thyroid cancer appears less than promising.
前哨淋巴结活检最近已被用于绘制分化型甲状腺癌患者的肿瘤淋巴管。目前，争议集中在该技术在分化型甲状腺癌患者管理中的可行性和未来作用。对目前有关对诊断为分化型甲状腺癌的患者进行前哨淋巴结活检的文献进行了综述。已利用活性染料技术、放射性示踪剂技术以及这两种技术的组合对甲状腺癌患者进行了前哨淋巴结活检。在当前文献中，前哨淋巴结识别的平均率为91%（范围为66%-100%），并且一旦识别出，前哨淋巴结在大多数患者中能准确预测颈部的疾病状态（范围为80%-100%）。对甲状腺癌患者进行前哨淋巴结活检的局限性包括甲状旁腺染色、识别引流至纵隔的淋巴结以及“穿透”效应。前哨淋巴结活检在技术上是可行的，但对于一种淋巴结转移的预后价值存在争议的疾病，前哨淋巴结活检在分化型甲状腺癌患者管理中的临床效用似乎不太乐观。
