Department of Surgery, CHA Ilsan Medical Center, Cha University School of Medicine, Goyang-si, South Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Head Neck. 2021 Nov;43(11):3276-3286. doi: 10.1002/hed.26808. Epub 2021 Jul 20.
This study aimed to evaluate usefulness of lateral sentinel lymph node biopsy (SLNB) in determining lateral neck dissection (LND) of patients with medullary thyroid cancer (MTC).
Sixteen patients with MTC were enrolled in the study from January 2013 to June 2019. Intratumoral injection of technetium (Tc)-99m phytate followed by lymphoscintigraphy was performed preoperatively. Lateral sentinel lymph nodes were detected by a collimated gamma probe and underwent frozen analysis. Ipsilateral LND was performed in all patients to assess lateral LN status.
The identification rate of sentinel lymph nodes (SLNs) detected by radioisotope was 87.5% (14 of 16 patients). The sensitivity, specificity, positive predictive value, and negative predictive value of frozen analyses were 66.7%, 100%, 100%, and 91.6%, respectively. Based on final histopathology, however, the diagnostic values of lateral SLNB were all 100%.
This study showed that lateral SLNB can be a promising surgical tool for decisions on LND in patients with MTC.
本研究旨在评估颈侧区前哨淋巴结活检（SLNB）在确定甲状腺髓样癌（MTC）患者颈侧区清扫术（LND）中的作用。
2013 年 1 月至 2019 年 6 月，共纳入 16 例 MTC 患者。术前进行锝（Tc）-99m 植酸钠瘤内注射及淋巴闪烁显像。使用准直伽马探头探测颈侧区前哨淋巴结，并进行冷冻分析。所有患者均行同侧 LND 以评估颈侧淋巴结状态。
放射性同位素检测到的前哨淋巴结（SLN）的识别率为 87.5%（16 例患者中的 14 例）。冷冻分析的敏感性、特异性、阳性预测值和阴性预测值分别为 66.7%、100%、100%和 91.6%。然而，根据最终的组织病理学结果，颈侧 SLNB 的诊断价值均为 100%。
本研究表明，颈侧 SLNB 可能是 MTC 患者行 LND 决策的一种有前途的手术工具。
