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. 1
patients 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. And we recommend this technique to support
decision to perform selective neck dissection in NO papillary thyroid cancer
patients. |
