Steck Jose Higino, Stabenow Elaine, Bettoni Gustavo Baldove, Steck Samuel, Cernea Claudio Roberto
Clínica Onccape, Serviço de Cirurgia de Cabeça e Pescoço, Campinas, SP, Brasil.
Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Serviço de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2018 Jun;62(3):296-302. doi: 10.20945/2359-3997000000038. Epub 2018 May 17.
The objectives of this study were to evaluate the following: 1) the accuracy of sentinel lymph node mapping (SLNM) in detecting metastasis in papillary thyroid carcinoma (PTC), and 2) if SLNM could modify the American Joint Committee on Cancer (AJCC) staging of previous cN0 PTC patients.
Forty SLNM were performed prospectively in 38 consecutive cN0 PTC patients, with total thyroidectomy and elective compartment neck dissection (CND). The results of SLNM were compared with CND pathological findings to verify the accuracy of sentinel SLNM.
The mean patients' follow-up was 36 months. A total of 133 SLN were found at levels VI, II, III and IV. The SLN was identified in 95% of the patients with one false negative, 95% sensitivity, a 94% negative predictive value and 97% accuracy. The SLNM upstaging from cN0 to pN+ was 49%, and to stages III and IVa, it was 21%.
For this series of cN0 PTC patients: 1) SLNM accuracy was 97%, and 2) SLNM upstaging from cN0 to pN+ was 49%, whereas to stages III and IVa, it was 21%.
本研究的目的是评估以下内容：1）前哨淋巴结定位（SLNM）在检测甲状腺乳头状癌（PTC）转移中的准确性，以及2）SLNM是否可以改变美国癌症联合委员会（AJCC）对既往cN0 PTC患者的分期。
对38例连续的cN0 PTC患者前瞻性地进行了40次SLNM，并行甲状腺全切除术及选择性颈淋巴结清扫术（CND）。将SLNM的结果与CND的病理结果进行比较，以验证前哨SLNM的准确性。
患者平均随访36个月。在Ⅵ、Ⅱ、Ⅲ和Ⅳ区共发现133个前哨淋巴结。95%的患者成功识别出前哨淋巴结，假阴性1例，敏感性95%，阴性预测值94%，准确性97%。SLNM将分期从cN0上调至pN+的比例为49%，上调至Ⅲ期和Ⅳa期的比例为21%。
对于这一系列cN0 PTC患者：1）SLNM的准确性为97%，2）SLNM将分期从cN0上调至pN+的比例为49%，上调至Ⅲ期和Ⅳa期的比例为21%。
