Schilling Clare, Collins Lisette, Farrow Adrian, McGurk Mark, Bisase Brian, Kerawala Cyrus, Wan Simon, Hall Gill, Thavaraj Selvam
Head and Neck Academic Centre, University College London, London, UK.
Head & Neck Surgery, University College London Hospital, London, UK.
Laryngoscope. 2024 Mar;134(3):1278-1281. doi: 10.1002/lary.30996. Epub 2023 Aug 23.
Sentinel node biopsy (SNB) is a surgical staging test in which sentinel nodes (SNs) undergo intensive histological analysis. SNB diagnoses early cancer spread, but can also reveal unexpected findings within the SNs. We review cases of incidental thyroid cells (TC) found in SNs from patients with oral squamous cell carcinoma (OSCC) to assess the prevalence of TC, and the clinical significance of these.
Multicenter retrospective review of SNB performed for cT1-T2N0 OSCC. Incidental TC were identified by TTF-1 or thyroglobulin positivity. Anatomical location of nodes containing TC, TC morphology, and ongoing management/follow up of this incidental finding was recorded. Neck dissections performed during the same period were reviewed to establish the expected incidence of TC in neck nodes without serial sectioning analysis.
278 SNB cases were reviewed. Ten procedures detected TC in nine patients (10/278, 3.6%). During the same time period 725 neck dissections were performed, six containing TCs (6/725, 0.8%). One patient underwent SNB twice with TC identified on both occasions. Three patients had both OSCC metastasis and thyroid cells. All SNB patients with TC identified underwent thyroid USS with no primary tumours identified. Three patients underwent thyroidectomy, in all cases no primary thyroid tumour was found.
Prevalence of incidental TC in SNs appears to be higher than that reported in neck dissections, these are not likely to be clinically relevant and can be managed on a conservative basis in the absence of clear metastatic features.
Multicentre retrospective cohort study, 3 Laryngoscope, 134:1278-1281, 2024.
前哨淋巴结活检（SNB）是一种手术分期检查，在前哨淋巴结（SN）中进行深入的组织学分析。SNB可诊断早期癌症转移，但也可能在前哨淋巴结中发现意外情况。我们回顾了口腔鳞状细胞癌（OSCC）患者前哨淋巴结中偶然发现甲状腺细胞（TC）的病例，以评估TC的发生率及其临床意义。
对cT1-T2N0 OSCC患者进行的SNB进行多中心回顾性研究。通过甲状腺转录因子-1（TTF-1）或甲状腺球蛋白阳性来识别偶然发现的TC。记录含有TC的淋巴结的解剖位置、TC形态以及对这一偶然发现的后续处理/随访情况。回顾同期进行的颈部清扫术，以确定在未进行连续切片分析的情况下颈部淋巴结中TC的预期发生率。
共回顾了278例SNB病例。10例手术在9名患者中检测到TC（10/278，3.6%）。同期进行了725例颈部清扫术，其中6例含有TC（6/725，0.8%）。1例患者接受了两次SNB，两次均发现了TC。3例患者同时存在OSCC转移和甲状腺细胞。所有发现TC的SNB患者均接受了甲状腺超声检查，未发现原发性肿瘤。3例患者接受了甲状腺切除术，所有病例均未发现原发性甲状腺肿瘤。
前哨淋巴结中偶然发现TC的发生率似乎高于颈部清扫术中报告的发生率，这些TC不太可能具有临床相关性，在没有明确转移特征的情况下可进行保守处理。
多中心回顾性队列研究，3《喉镜》，134:1278 - 1281，2024年。
