[甲状腺乳头状癌患者的前哨淋巴结活检]

Nenkov R, Radev R, Madzhov R, Krasnaliev I

Khirurgiia (Sofiia). 2006(6):55-8.

UNLABELLED

The concept of sentinel lymph node (SLN) has been proven to be successful and accurate in surgical decision making for the treatment of some solid tumors. The AIM of this study is to investigate the feasibility and accuracy of the SLN biopsy in patients with papillary thyroid carcinoma.

PATIENTS AND METHODS

Twenty eight patients underwent SLN biopsy for the period from 01 January 2003 to 30 June 2006 in our institution.Twenty three of them were females and 5 males, at the age of 21 to 57 years. All patients have had a solitary thyroid nodule, 0.8 to 3.0 cm in size. Patients with any palpable or ultrasonografically detectable cervical LNs or history for previous neck surgery and/or radiation in the same region have been excluded from the study. Blue dye (Patent blue V) injection around or inside the thyroid nodule was utilized for the SLN detection followed by SLN biopsy.

RESULTS

SLN have been detected and obtained in all 22 patients with papillary thyroid carcinoma. One SLN in the central compartment was found in 19 (40,9%) patients and one in lateral compartment in 3 (13,6%) patients. In 2 (9,1%) patients one SLN was found in both, central and lateral compartments. Metastasis in SLN was found in 9 (40,9%) patients. SLN in last 13 (59,1%) patients were negative for metastases. From patients with metastasis-positive SLN, metastasis in a next regional lymph node was found in 3 (13,6%) patients. In the remaining 6 cases next lymph nodes in both compartments were metastasis-negative. Metastatic disease in regional lymph nodes was not found in anyone from the patients with metastasis-negative SLN.

CONCLUSIONS

Sentinel lymph node biopsy provides reliable information about the pathomorphological lymph node status in patients with papillary thyroid carcinoma, thus making possible to avoid unnecessary neck dissections and to minimize the risk from local surgical complications and disease recurrencies. The initial results with SLN biopsy give us a reason to accept this technique as a feasible, accurate and safe option in the surgical treatment of papillary thyroid carcinoma.

未标注

前哨淋巴结（SLN）的概念已被证明在某些实体瘤治疗的手术决策中是成功且准确的。本研究的目的是探讨前哨淋巴结活检在甲状腺乳头状癌患者中的可行性和准确性。

患者与方法

2003年1月1日至2006年6月30日期间，我院对28例患者进行了前哨淋巴结活检。其中23例为女性，5例为男性，年龄在21至57岁之间。所有患者均有一个孤立性甲状腺结节，大小为0.8至3.0厘米。有任何可触及或超声检查可发现的颈部淋巴结或既往颈部手术和/或同一区域放疗史的患者被排除在研究之外。通过在甲状腺结节周围或内部注射蓝色染料（专利蓝V）来检测前哨淋巴结，随后进行前哨淋巴结活检。

结果

所有22例甲状腺乳头状癌患者均检测并获取到了前哨淋巴结。19例（40.9%）患者在中央区发现1个前哨淋巴结，3例（13.6%）患者在侧区发现1个前哨淋巴结。2例（9.1%）患者在中央区和侧区均发现1个前哨淋巴结。9例（40.9%）患者的前哨淋巴结存在转移。最后13例（59.1%）患者的前哨淋巴结未发现转移。在前哨淋巴结转移阳性的患者中，3例（13.6%）患者的下一个区域淋巴结发现转移。其余6例患者两个区域的下一个淋巴结均未发现转移。在前哨淋巴结转移阴性的患者中，未发现任何人的区域淋巴结有转移性疾病。