Aim: Is to evaluate the role of sentinel lymph node biopsy (SLNB) in diagnosis of lateral
nodal involvement in NO papillary thyroid cancer patients.
Methods: 20 patients were included in this study; total thyroidectomy with dissection of the
central neck compartment was done in all patients. 0.5 ml of 2% methylene blue dye was injected
into the primary tumour; blue stained SLN in lateral neck was identified and examined by frozen
section. If any of the SLNs were positive on the frozen section, selective neck dissection (levels
II-IV) was performed during same operation. In false-negative cases of SLNs reoperation was
carried out after 1 week.
Results: There were 6.7% false-negative rate; 100% specificity; 80% sensitivity, 93% negative
predictive value; 100% positive predictive value, with 94.7% overall accuracy. Postoperative
transient recurrent laryngeal nerve palsy occurred in 2 patients; but none of the patients had
permanent nerve palsy. One patient required calcium supplement on discharge; however, no
patient developed permanent hypocalcaemia.
Conclusion: SLNB is an easy and accurate method for assisting the diagnosis of metastasis
in the lateral neck compartment, and it could reduce the risk of complications of thyroid surgery.
We recommend this technique to support the decision to perform selective neck dissection in
NO papillary thyroid cancer patients.
Key words: Papillary thyroid cancer, sentinel lymph node, lateral neck compartment |
