Kaczka Krzysztof, Luks Bartłomiej, Jasion Jakub, Pomorski Lech
Department of General and Oncological Surgery, Medical University of Łódź, Poland Maria Sklodowska-Curie Memorial Hospital, Zgierz, Poland.
Contemp Oncol (Pozn). 2013;17(2):184-9. doi: 10.5114/wo.2013.34623. Epub 2013 Apr 29.
To determine the feasibility of sentinel lymph node biopsy (SLNB) for the evaluation of the cervical lymph node status in patients with thyroid tumors.
Twenty-three patients with suspected thyroid cancer were enrolled in the study. 0.5-1.0 ml of 1% Patent Blue dye was injected intratumorally. After SLNB, thyroidectomy and proper lymphadenectomy were performed.
Sentinel lymph node was detected in 20 (86.9%) patients. Thirty-one SLNs were found - 21 (67.7%) were located in the central neck compartment, 4 (12.9%) in the lateral neck compartment, 6 (19.4%) in the upper mediastinum. The number of SLNs ranged from 1 to 3 (mean 1.6). Sentinel lymph node was positive in 5 (25%) patients, negative in 15 (75%) in the final histopathology. Sentinel lymph nodes were located only in the central neck compartment in 13 patients, and in both the central and lateral neck compartments in 2 patients. In one patient, SLNs were located only in the central neck compartment and upper mediastinum. Three patients had SLNs only in the upper mediastinum, while one had them only in the lateral neck compartment. In one patient a node regarded as SLN was negative, while there were metastases in removed non-sentinel lymph nodes (NSLNs). In two patients, histopathology of SLNs showed that they were actually parathyroid glands.
Our results confirm that thyroid cancer SLNB is rather easy to carry out. Its performance along with intraoperative examination can help to avoid unnecessary lymphadenectomy. However, it should be kept in mind that parathyroid glands can be stained and removed by mistake during SLNB.
确定前哨淋巴结活检（SLNB）用于评估甲状腺肿瘤患者颈部淋巴结状态的可行性。
23例疑似甲状腺癌患者纳入本研究。将0.5 - 1.0毫升1%专利蓝染料瘤内注射。SLNB后，行甲状腺切除术及适当的淋巴结清扫术。
20例（86.9%）患者检测到前哨淋巴结。共发现31个前哨淋巴结，其中21个（67.7%）位于颈部中央区，4个（12.9%）位于颈部外侧区，6个（19.4%）位于上纵隔。前哨淋巴结数量为1至3个（平均1.6个）。最终组织病理学检查显示，5例（25%）患者前哨淋巴结阳性，15例（75%）阴性。13例患者的前哨淋巴结仅位于颈部中央区，2例患者的前哨淋巴结同时位于颈部中央区和外侧区。1例患者的前哨淋巴结仅位于颈部中央区和上纵隔。3例患者的前哨淋巴结仅位于上纵隔，1例患者的前哨淋巴结仅位于颈部外侧区。1例患者被视为前哨淋巴结的淋巴结为阴性，但切除的非前哨淋巴结（NSLN）有转移。2例患者前哨淋巴结的组织病理学检查显示其实际为甲状旁腺。
我们的结果证实甲状腺癌SLNB操作相对容易。其与术中检查相结合有助于避免不必要的淋巴结清扫术。然而，应牢记在SLNB过程中甲状旁腺可能被误染和切除。
