Hospital Universitario Basurto, Bilbao, Vizcaya, Spain.
Servicio de Radiodiagnóstico, Departamento de Ecografía Intervencionista, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain.
Cir Esp (Engl Ed). 2022 Jul;100(7):416-421. doi: 10.1016/j.cireng.2022.04.022. Epub 2022 May 6.
The presence of lymph nodes metastasis in papillary thyroid cancer (PTC) 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 PTC 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 (SN).
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.
53 of the 55 patients (96,36%) there was the SN detection. The FN 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 of 92,45%.
The SLNB is a valid technique for use in patients suffering from papillary thyroid cancer with a high diagnostic accuracy.
在甲状腺乳头状癌（PTC）中存在淋巴结转移会改变手术切除的类型以及术后使用碘 131 治疗的适应证。这种治疗方法基于诊断测试的结果，如颈部超声。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。它可以补充超声的结果。本研究旨在验证 SLNB 用于诊断甲状腺乳头状癌的淋巴结转移。
对 2012 年 2 月至 2015 年 2 月期间因临床或影像学无淋巴结受累怀疑而接受 PTC 治疗的 55 例患者进行前瞻性队列观察研究，随访时间为 6 至 8 年。使用 Tc 与肿瘤内纳米胶体和伽马相机的便携式管来检测前哨淋巴结（SN）。
年龄、性别、组织学、分析和术前及术后分期。计算技术的敏感性、特异性和预测值。通过计算该检测的可探测性和假阴性结果来确定验证。
55 例患者中有 53 例（96.36%）检测到 SN。FN 为 4 例（7.5%）。在其余患者中，进行 SLNB 后，24 例（48.9%）保持 N0，14 例（28.5%）为 N1a，11 例（22.4%）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%，PPV 为 100%，NPV 为 85.71%。诊断准确率为 92.45%。
SLNB 是一种用于甲状腺乳头状癌患者的有效技术，具有较高的诊断准确性。
