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[Sentinel lymph node biopsy in papillary thyroid cancer].

Bin Zhang¹, Dan-gui Yan, Lin Liu

¹Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. docbinzhang@hotmail.com

Zhonghua Zhong Liu Za Zhi [Chinese Journal of Oncology]

|December 18, 2010

Summary

Sentinel lymph node biopsy (SLNB) reliably detects papillary thyroid carcinoma metastasis. This method aids in deciding on neck dissection for cN0 patients.

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Area of Science:

Oncology
Surgical Pathology

Background:

Papillary thyroid carcinoma (PTC) management requires accurate staging of cervical lymph node involvement.
Sentinel lymph node biopsy (SLNB) is a minimally invasive technique to assess nodal metastasis.

Purpose of the Study:

To evaluate the reliability and feasibility of SLNB for papillary thyroid carcinoma using a combination of imaging and staining techniques.
To determine the accuracy of SLNB in detecting lymph node metastasis in clinically node-negative (cN0) patients.

Main Methods:

A study involving 23 cN0 PTC patients who underwent SLNB.
Combination techniques included preoperative lymphoscintigraphy, intra-operative gamma probe detection, and methylene blue staining.
SLN biopsy results were compared with frozen sections and routine neck dissection histology.

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Main Results:

Sentinel lymph nodes (SLNs) were identified in 100% of cases using lymphoscintigraphy and gamma probe.
The overall accuracy of SLNB was 91.3%, with a positive predictive value of 100% and a negative predictive value of 81.8%.
Metastasis was detected in SLNs in 12 patients, with some discrepancies noted between frozen section and routine histology.

Conclusions:

SLNB is a feasible and valuable technique for detecting cervical lymph node metastasis in cN0 papillary thyroid carcinoma.
SLNB can assist in decision-making regarding the extent of neck dissection, potentially avoiding unnecessary procedures.