Expósito Rodríguez Amaia, Corta Gómez Igone, Domínguez Ayala Maite, García Carrillo Maitane, González García Ana Isabel, Gutiérrez Rodríguez Maria Teresa, Oleaga Alday Amelia, Paja Fano Miguel, Rodríguez Iriarte María Luisa, Ugalde Olano Aitziber, Zabala Landa Rosa
Hospital Universitario Basurto, Bilbao, Vizcaya, España.
Servicio de Radiodiagnóstico, Departamento de Ecografía Intervencionista, Hospital Universitario Basurto, Bilbao, Vizcaya, España.
Cir Esp (Engl Ed). 2021 May 12. doi: 10.1016/j.ciresp.2021.04.010.
The presence of lymph nodes metastasis in papillary thyroid cancer modifies the type of surgical resection as well as the indication of the treatment with I in the postoperative period. This therapeutic approach is based on the results of the diagnostic tests, like the cervical ultrasonography. Currently other methods of diagnostic are tested as selective sentinel lymph node biopsy (SLNB). It can complement to the ultrasound results. The aim was to validate the SLNB for use in the diagnosis of lymph node metastasis by papillary thyroid cancer.
Observational prospective cohort study of 55 patients who underwent papillary thyroid cancer without suspicion of lymph node involvement clinical or radiological, since February 2012 through February 2015, with a follow-up between 6 and 8 years. It was used Tc with intratumoral nanocoloid and a portable tube of the gamma camera for the detection of the sentinel node.
age, gender, histological, analytical and preoperative and postoperative staging. The sensitivity, specificity and predictive values of technique was calculated. The validation was determined by calculating the detectability and the false negative results of the test.
In 53 of the 55 patients (96.36%) there was the sentinel node detection. The false negative were 4 patients (7.5%). Of the rest, after applying the SLNB, 24 (48.9%) were kept as N0, 14 (28.5%) became N1a and 11 (22.4%) were classified as N1b. The differences observed in the study were significant (P<.05). The sensitivity was 86.21%, the specificity of 100%, the PPV was 100% and the NPV of 85.71%. The diagnostic accuracy was 92.45%.
The SLNB is a valid technique for use in patients suffering from papillary thyroid cancer with a high diagnostic accuracy.
甲状腺乳头状癌中淋巴结转移的存在会改变手术切除的类型以及术后碘治疗的指征。这种治疗方法基于诊断测试的结果，如颈部超声检查。目前，其他诊断方法如选择性前哨淋巴结活检（SLNB）也在进行测试。它可以补充超声检查的结果。目的是验证SLNB在诊断甲状腺乳头状癌淋巴结转移中的应用。
对2012年2月至2015年2月期间55例临床及影像学检查均未怀疑有淋巴结受累的甲状腺乳头状癌患者进行前瞻性队列观察研究，随访6至8年。使用肿瘤内纳米胶体锝和便携式γ相机管来检测前哨淋巴结。
年龄、性别、组织学、分析指标以及术前和术后分期。计算该技术的敏感性、特异性和预测值。通过计算检测率和测试的假阴性结果来确定验证情况。
55例患者中有53例（96.36%）检测到了前哨淋巴结。假阴性有4例（7.5%）。其余患者在应用SLNB后，24例（48.9%）维持为N0，14例（28.5%）变为N1a，11例（22.4%）被分类为N1b。研究中观察到的差异具有统计学意义（P<0.05）。敏感性为86.21%，特异性为100%，阳性预测值为100%，阴性预测值为85.71%。诊断准确性为92.45%。
SLNB是一种用于甲状腺乳头状癌患者的有效技术，诊断准确性高。
