The Utility of Sentinel Lymph Node Biopsy in Papillary Thyroid Carcinoma with Occult Lymph Nodes
| Autor: | Feilin Cao, Xingqiang Yan, Chengze Chen, Xiao-Hua Zhang, Rui-chao Zeng, En-dong Chen, Zhaosheng Ma |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Sentinel lymph node Thyroid Gland lcsh:Medicine Sensitivity and Specificity Metastasis Thyroid carcinoma Young Adult Biopsy Carcinoma Humans Medicine Thyroid Neoplasms lcsh:Science Aged Multidisciplinary medicine.diagnostic_test Sentinel Lymph Node Biopsy business.industry lcsh:R Thyroidectomy Reproducibility of Results Neck dissection Middle Aged medicine.disease Carcinoma Papillary Surgery Lymphatic Metastasis Neck Dissection lcsh:Q Female Lymph Nodes Lymph Radiology business Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Vol 10, Iss 6, p e0129304 (2015) |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0129304 |
| Popis: | Background The sentinel lymph node (SLN) is defined as the first draining node from the primary lesion, and it has proven to be a good indicator of the metastatic status of regional lymph nodes in solid tumors. The aim of this study was to evaluate the clinical application of SLN biopsy (SLNB) in papillary thyroid carcinoma (PTC) with occult lymph nodes. Methods From April 2006 to October 2012, 212 consecutive PTC patients were treated with SLNB using carbon nanoparticle suspension (CNS). Then, the stained nodes defined as SLN were collected, and prophylactic central compartment neck dissection (CCND) followed by total thyroidectomy or subtotal thyroidectomy were performed. All the samples were sent for pathological examination. Results There were 78 (36.8%) SLN metastasis (SLNM)-positive cases and 134 (63.2%) SLNM-negative cases. The sensitivity, specificity, positive and negative predictive values, and false-positive and false-negative rates of SLNB were 78.8%, 100%, 100%, 84.3%, 0%, and 21.2%, respectively. The PTC patients with SLNM were more likely to be male (48.2% vs. 32.7%, p = 0.039) and exhibited multifocality (52.6% vs. 33.3%, p = 0.025) and extrathyroidal extension (56.7% vs. 33.5%, p = 0.015). A greater incidence of non-SLN metastases in the central compartment was found in patients with SLNM (41/78, 52.6%) than in those without SLNM (21/134, 15.7%; p < 0.05). However, the SLNM-negative PTC patients with non-SLN metastases were more likely to be male (37.9% vs. 9.5%, p < 0.05). Conclusions The application of SLNB using CNS is technically feasible, safe, and useful, especially for male patients with co-existing multifocality and extrathyroidal extension. However, the sensitivity of SLNB must be improved and its false-negative rate reduced before it can be a routine procedure and replace prophylactic CCND. More attention should be paid to PTC patients (especially males) without SLNM for signs of non-SLN metastases. |
| Databáze: | OpenAIRE |
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