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前哨淋巴结活检在甲状腺微小乳头状癌中的应用价值

Utility of sentinel lymph node biopsy in papillary thyroid microcarcinoma.

作者信息

Kim Hyun Yul, Kim Dong-Il, Jung Chang Shin, Lee Seung Joo, Im Dong Won, Jung Youn Joo, Yeom Jeong-A, Choi Jeong Bum

机构信息

Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.

Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.

出版信息

Korean J Clin Oncol. 2021 Dec;17(2):117-121. doi: 10.14216/kjco.21018. Epub 2021 Dec 31.

Abstract

PURPOSE

There are many studies on sentinel lymph node (SLN) biopsy in thyroid carcinoma but SLN biopsy (SLNB) in papillary thyroid carcinoma (PTC) remains open to debate. Therefore in this retrospective study, the usefulness of SLNB in thyroid carcinoma patients who had micro-PTC without cervical lymphadenopathy was assessed.

METHODS

SLNB was performed in 114 patients who were diagnosed with micro-PTC in a single lobe without palpable or ultrasound-detected lymph node at the tertiary center between January 2012 and December 2013. After SLNB, all patients underwent total thyroidectomy and central neck dissection or thyroid lobectomy and central neck dissection of the single side.

RESULTS

SLNs were identified in 112 of 114 patients with 41 positive SLNs and 71 negative SLNs on intraoperative frozen sections. However, eight negative patients were found to be positive in the final pathology. Sentinel node identification rate and false negative value of SLNB were 98.2% and 11.3%, respectively. In the univariate analysis, higher lymph node metastasis was detected in men than in women. Higher detection number of SLN showed higher probability of lymph node metastasis.

CONCLUSION

SLNB may be helpful in papillary thyroid cancer, especially in male patients. Also, it is useful for the staging of nodal status and clearance of persistent disease.

摘要

目的

关于甲状腺癌前哨淋巴结活检已有多项研究,但甲状腺乳头状癌(PTC)的前哨淋巴结活检(SLNB)仍存在争议。因此,在这项回顾性研究中,评估了SLNB对微小PTC且无颈淋巴结肿大的甲状腺癌患者的有效性。

方法

2012年1月至2013年12月期间,在一家三级中心对114例被诊断为单叶微小PTC且无可触及或超声检测到淋巴结的患者进行了SLNB。SLNB后,所有患者均接受了全甲状腺切除术及中央区颈淋巴结清扫术,或甲状腺叶切除术及单侧中央区颈淋巴结清扫术。

结果

114例患者中有112例术中冰冻切片发现前哨淋巴结,其中41例前哨淋巴结阳性,71例阴性。然而,最终病理检查发现8例术中阴性患者为阳性。SLNB的前哨淋巴结识别率和假阴性值分别为98.2%和11.3%。单因素分析显示,男性的淋巴结转移率高于女性。前哨淋巴结检出数量越多,淋巴结转移的可能性越高。

结论

SLNB对甲状腺乳头状癌可能有帮助,尤其是男性患者。此外,它对淋巴结状态分期和清除残留疾病也有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4184/9942750/2c767396b5f4/kjco-17-2-117f1.jpg

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