Puccini Marco, Ambrosini Carlo Enrico, Rossi Leonardo, De Napoli Luigi, Materazzi Gabriele
Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
Endocrine Surgery Unit, Department of Surgery, University Hospital of Pisa, Pisa, Italy.
Front Med (Lausanne). 2023 Jun 20;10:1163151. doi: 10.3389/fmed.2023.1163151. eCollection 2023.
In this paper we describe the current status of sentinel node mapping (SNM) in thyroid tumors and its potential perspectives. SNM in thyroid cancer has been tested since the end of the twentieth century, mainly in papillary thyroid cancer (PTC) and in medullary thyroid cancer (MTC). In PTC, it has been employed to find occult lymph node metastases in the central compartment of the neck as an alternative or indication for prophylactic dissection, by several methods. All of them have proven effective in spotting sentinel nodes, but the results have been somewhat diminished by uncertainty about the clinical significance of occult metastases in differentiated thyroid cancer. SNM in MTC has also been used to find occult lymph node metastases in the lateral compartments of the neck, also with excellent results hindered by a similar doubt about the real clinical significance of MTC micrometastases. Well designed, adequately sized randomized controlled trials are lacking, so SNM in thyroid tumors remains an interesting yet experimental methodology. New technology is emerging that could facilitate such studies, which could add solid information about the clinical significance of occult neck metastases in thyroid cancer.
在本文中，我们描述了甲状腺肿瘤前哨淋巴结定位（SNM）的现状及其潜在前景。自20世纪末以来，一直在测试甲状腺癌中的SNM，主要用于甲状腺乳头状癌（PTC）和甲状腺髓样癌（MTC）。在PTC中，它已被用于通过多种方法在颈部中央区发现隐匿性淋巴结转移，作为预防性清扫的替代方法或指征。所有这些方法在发现前哨淋巴结方面都已被证明是有效的，但由于分化型甲状腺癌隐匿性转移的临床意义存在不确定性，结果有所减弱。MTC中的SNM也已被用于发现颈部外侧区的隐匿性淋巴结转移，同样由于对MTC微转移的实际临床意义存在类似疑问，结果也受到了影响。缺乏设计良好、规模适当的随机对照试验，因此甲状腺肿瘤中的SNM仍然是一种有趣但仍处于实验阶段的方法。正在出现的新技术可能会促进此类研究，这些研究可能会增加关于甲状腺癌隐匿性颈部转移临床意义的可靠信息。
