Lateral cervical lymph node mapping in papillary thyroid carcinoma: a prospective cohort study
10.3969/j.issn.1000-8179.2018.20.675
- VernacularTitle:示踪甲状腺乳头状癌侧颈淋巴结的前瞻性研究
- Author:
Naisi HUANG
1
,
2
;
Ben MA
;
Qing GUAN
;
Yunjun WANG
;
Li ZHOU
;
Wenjun WEI
;
Zhongwu LU
;
Shuwen YANG
;
Weibo XU
;
Jun XIANG
;
Qinghai JI
;
Yu WANG
Author Information
1. 复旦大学附属肿瘤医院头颈外科 上海市200032
2. 复旦大学上海医学院肿瘤学系
- Keywords:
papillary thyroid carcinoma;
lateral cervical lymph node;
lymph node mapping;
neck dissection;
sentinel lymph node biopsy
- From:
Chinese Journal of Clinical Oncology
2018;45(20):1053-1056
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the value of nanoparticles (CN) in lateral cervical lymph node mapping in papillary thyroid carcinoma using carbon. Methods: Thyroid cancer patients with suspicious lymph node metastasis but without typical signs of metastatic disease from March 2016 to November 2017 in Fudan University Shanghai Cancer Center were prospectively included in the cohort. Neck dissection was performed in all patients (compartmentsⅡ-Ⅴ). Suspicious lateral lymph node metastasis was identified using pre-operative ultrasound or computed tomography. CN were used for lymph node mapping during surgery. Results: A total of 70 surgeries were performed in 67 patients, among which 57 were found to have lateral lymph node metastasis (81.4%). The median number of CN-dyed lateral lymph nodes was 6. Compartment IV had the highest number of CN-dyed positive lymph nodes as well as the highest rate of metastasis, followed by compartmentⅢ. In compartmentsⅢandⅣ, the incidence of lymph node metastasis was significantly higher in the CN-dyed group than in the CN-undyed group (P<0.001). When the final pathology of neck dissection was set as the gold standard, lateral CN-dyed lymph node biopsy was found to have a sensitivity of 86.0%; its negative predictive value was 61.9% and its overall accuracy was 88.6%. Conclusions:Injection of CN during surgery was a potential method of mapping lateral lymph nodes in papillary thyroid carcinoma. CompartmentⅢ-ⅣCN-dyed lymph node biopsy had a satisfactory sensitivity and thus, served as a reasonable range for lymph node biopsy.
