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[甲状腺乳头状癌患者前哨淋巴结检测的淋巴结图谱绘制]

[Lymph nodes mapping for detection of sentinel nodes in patients with papillary thyroid cancer].

作者信息

Nakano Shizuo, Uenosono Yoshikazu, Ehi Katsuhiko, Arigami Takaaki, Higashi Yasushi, Maeda Tetsu, Kijima Yuuko, Natsugoe Shouji, Aikou Takashi

机构信息

Department of Surgical Oncology and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-0075, Japan.

出版信息

Gan To Kagaku Ryoho. 2004 May;31(5):801-4.

Abstract

We examined the feasibility of sentinel lymph node biopsy for papillary thyroid cancer. In the dye injection method, 1% of isosulfan blue dye was injected around the tumor of 32 patients intra-operatively, and in the radioisotope (RI) colloid injection method, 99mTc-tin colloid was injected in 23 patients 1 day preoperatively. Lymph node mapping for detection of sentinel nodes was performed after thyroidectomy and central and modified lateral neck lymph node dissections. All dissected nodes were examined postoperatively by hematoxylineosin staining to determine whether or not metastasis was present. In the dye injection method, sentinel lymph nodes were identified in 30 (94%) of the 32 patients. Lymph node metastases were found in 14 patients, and some sentinel lymph nodes had papillary cancer metastasis in 13 patients. There was only 1 false-negative case. Sensitivity and accuracy of sentinel lymph node biopsy was 93% (13/14) and 97% (29/30). With the RI method, detection rate, sensitivity and accuracy of sentinel lymph node biopsy was 96% (22/23), 90% (9/10) and 95% (21/22), respectively. Our preliminary study indicated that sentinel lymph node biopsy was feasible in patients with thyroid cancer. It may be helpful in avoiding unnecessary lymph node dissection and improving quality of life in patients with thyroid cancer.

摘要

我们研究了前哨淋巴结活检用于甲状腺乳头状癌的可行性。在染料注射法中,术中对32例患者的肿瘤周围注射1%的异硫蓝染料,在放射性同位素(RI)胶体注射法中,术前1天对23例患者注射99mTc-锡胶体。甲状腺切除及中央区和改良侧颈淋巴结清扫术后进行前哨淋巴结检测的淋巴结图谱绘制。术后对所有切除的淋巴结进行苏木精-伊红染色检查,以确定是否存在转移。在染料注射法中,32例患者中有30例(94%)识别出前哨淋巴结。14例患者发现有淋巴结转移,13例患者的一些前哨淋巴结有乳头状癌转移。仅1例假阴性病例。前哨淋巴结活检的敏感性和准确性分别为93%(13/14)和97%(29/30)。采用RI法时,前哨淋巴结活检的检出率、敏感性和准确性分别为96%(22/23)、90%(9/10)和95%(21/22)。我们的初步研究表明,前哨淋巴结活检在甲状腺癌患者中是可行的。它可能有助于避免不必要的淋巴结清扫,并改善甲状腺癌患者的生活质量。

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